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NPI Code Detail

MEDICARE: MRS. SUSAN FITZGERALD

MEDICARE:  MRS. SUSAN  FITZGERALD
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
1225X00000XOccupational Therapist106197TX

General Provider Information

NPI Number : 1073378212
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN FITZGERALD
Provider Business Mailing Address
First Line : 600 JOSHUA RD
Second Line :
City : LANTANA
State : TX
Zip : 76226-4361
Country : US
Telephone Number : 214-505-8685
Fax Number :
Provider Business Practice Location Address
First Line : 1101 OHIO DR STE 105
Second Line :
City : PLANO
State : TX
Zip : 75093-5331
Country : US
Telephone Number : 972-599-9594
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2024
Last Update Date : 02/16/2024

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Directions to “ MRS. SUSAN FITZGERALD ” Practice Location

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