=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871706549
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SUSANA FURBER F.N.P.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/08/2007
-----------------------------------------------------
Last Update Date | 06/20/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3220 S JACKSON RD
-----------------------------------------------------
City | EDINBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78539-6666
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-380-1933
-----------------------------------------------------
Fax | 956-380-6929
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2429
-----------------------------------------------------
City | EDINBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78540-2429
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-380-1833
-----------------------------------------------------
Fax | 956-380-6929
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 638557
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------