Healthcare Provider Details

I. General information

NPI: 1780872762
Provider Name (Legal Business Name): SUSAN E DOZIER, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 03/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8240 N MOPAC EXPY STE 355
AUSTIN TX
78759-8894
US

IV. Provider business mailing address

8240 N MOPAC EXPY STE 355
AUSTIN TX
78759-8894
US

V. Phone/Fax

Practice location:
  • Phone: 512-527-9020
  • Fax: 512-527-9000
Mailing address:
  • Phone: 512-527-9020
  • Fax: 512-527-9000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberH8011
License Number StateTX

VIII. Authorized Official

Name: SUSAN E DOZIER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 512-527-9020