Healthcare Provider Details

I. General information

NPI: 1538382379
Provider Name (Legal Business Name): BRENDA SUSAN COSENS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRENDA SUSAN SUTER R.N.

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 NORTH ZANG BLVD
DALLAS TX
75208
US

IV. Provider business mailing address

732 NORTH WINDOMERE AVENUE
DALLAS TX
75208
US

V. Phone/Fax

Practice location:
  • Phone: 214-948-2416
  • Fax: 214-948-2475
Mailing address:
  • Phone: 214-948-2416
  • Fax: 214-948-2475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number091216
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number520624
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: