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General NPI Number Information
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NPI Number | 1215447883
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Entity Type | Individual
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Provider Name | SUSAN MICHELE GREEN DPT
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Gender | Female
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Dates
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Enumeration Date | 10/09/2017
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 1067 FM 306 STE 604
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City | NEW BRAUNFELS
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State | TX
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Zip | 78130-6897
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Country | US
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Telephone | 830-217-2956
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Fax | 830-217-3406
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Provider Business Mailing Address
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Address Line | 2903 GREAT OAKS DR
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City | SAN MARCOS
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State | TX
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Zip | 78666-1008
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Country | US
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Telephone | 512-393-1906
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Fax |
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 1293407
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License Number State | TX
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