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General NPI Number Information
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NPI Number | 1487938734
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Entity Type | Organization
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Legal Business Name | SUSAN HOMAN MD PLLC
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Dates
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Enumeration Date | 10/05/2011
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 3030 NACOGOCHES ROAD SUITE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78217
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Country | US
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Telephone | 210-826-9599
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Fax |
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Provider Business Mailing Address
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Address Line | 3030 NACOGOCHES ROAD SUITE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78217
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Country | US
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Telephone | 210-826-9599
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | SUSAN ELIZABETH HOMAN
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Credential | M.D.
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Telephone | 210-826-9599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | H4960
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License Number State | TX
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