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General NPI Number Information
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NPI Number | 1114091675
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Entity Type | Individual
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Provider Name | SUSAN KATHLEEN DUBOIS M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 06/10/2016
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Provider Practice Location Address
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Address Line | 2901 MONTOPOLIS DR
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City | AUSTIN
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State | TX
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Zip | 78741-6411
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Country | US
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Telephone | 512-978-9901
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Fax | 512-901-9765
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Provider Business Mailing Address
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Address Line | 2901 MONTOPOLIS DR
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City | AUSTIN
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State | TX
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Zip | 78741-6411
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Country | US
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Telephone | 512-978-9901
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Fax | 512-901-9765
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | H6178
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License Number State | TX
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