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NPI Code Detail

MEDICARE: SUSAN C ACOSTA

MEDICARE: SUSAN C ACOSTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistTX

General Provider Information

NPI Number : 1003951641
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN C ACOSTA
Provider Business Mailing Address
First Line : 12405 SUN TERRACE AVE
Second Line :
City : EL PASO
State : TX
Zip : 79938-4609
Country : US
Telephone Number : 915-373-5256
Fax Number :
Provider Business Practice Location Address
First Line : 1991 SAUL KLEINFELD DR
Second Line :
City : EL PASO
State : TX
Zip : 79936-3757
Country : US
Telephone Number : 610-991-2034
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 04/16/2008

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Directions to “ SUSAN C ACOSTA ” Practice Location

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