Healthcare Provider Details

I. General information

NPI: 1831138221
Provider Name (Legal Business Name): SUSAN MARIE ESCUDIER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 06/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7515 MAIN ST SUITE 740
HOUSTON TX
77030-4519
US

IV. Provider business mailing address

PO BOX 911230
DALLAS TX
75391-1230
US

V. Phone/Fax

Practice location:
  • Phone: 713-795-0202
  • Fax: 713-799-8290
Mailing address:
  • Phone: 972-997-8000
  • Fax: 972-437-9605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberH0332
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: