=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780872762
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUSAN E DOZIER, MD, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2007
-----------------------------------------------------
Last Update Date | 03/19/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8240 N MOPAC EXPY STE 355
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78759-8894
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-527-9020
-----------------------------------------------------
Fax | 512-527-9000
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8240 N MOPAC EXPY STE 355
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78759-8894
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-527-9020
-----------------------------------------------------
Fax | 512-527-9000
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | SUSAN E DOZIER
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 512-527-9020
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207ND0101X
-----------------------------------------------------
Taxonomy Name | MOHS-Micrographic Surgery Physician
-----------------------------------------------------
License Number | H8011
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------