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General NPI Number Information
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NPI Number | 1558350462
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Entity Type | Individual
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Provider Name | SUSAN CAROL GUBA MD
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Gender | Female
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Dates
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Enumeration Date | 10/14/2005
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Last Update Date | 12/11/2008
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Provider Practice Location Address
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Address Line | 8440 WALNUT HILL LN SUITE 600
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City | DALLAS
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State | TX
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Zip | 75231-3833
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Country | US
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Telephone | 214-739-1706
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Fax | 214-368-0056
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Provider Business Mailing Address
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Address Line | 8440 WALNUT HILL LN SUITE 600
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City | DALLAS
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State | TX
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Zip | 75231-3833
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Country | US
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Telephone | 214-739-1706
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Fax | 214-368-0056
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | L1056
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License Number State | TX
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