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General NPI Number Information
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NPI Number | 1639544794
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Entity Type | Individual
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Provider Name | SUSAN BABY NP
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Gender | Female
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Dates
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Enumeration Date | 12/01/2015
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Last Update Date | 12/01/2015
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Provider Practice Location Address
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Address Line | 901 S MOPAC EXPRESSWAY BUILDING II SUITE 130
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City | AUSTIN
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State | TX
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Zip | 78746-5776
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Country | US
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Telephone | 800-897-9177
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Fax | 800-470-8713
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Provider Business Mailing Address
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Address Line | 3961 CREEKSIDE LN
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City | CARROLLTON
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State | TX
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Zip | 75010-6398
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Country | US
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Telephone | 972-762-3033
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AP128480
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License Number State | TX
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