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General NPI Number Information
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NPI Number | 1407101744
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Entity Type | Individual
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Provider Name | SUSAN ELIZABETH ZANE M. D.
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Gender | Female
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Dates
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Enumeration Date | 07/23/2012
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Last Update Date | 11/05/2022
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Provider Practice Location Address
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Address Line | 100 PASCAL LN
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City | AUSTIN
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State | TX
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Zip | 78746-2506
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Country | US
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Telephone | 512-328-0990
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Fax |
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Provider Business Mailing Address
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Address Line | 100 PASCAL LN
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City | AUSTIN
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State | TX
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Zip | 78746-2506
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Country | US
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Telephone |
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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 | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | DR.0068882
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | TL0008441
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | J6421
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License Number State | TX
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