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NPI Code Detail

MEDICARE: DR. SUZZANE JEAN KOO M.D.

MEDICARE: DR. SUZZANE JEAN KOO M.D.
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
1207RC0200XCritical Care Medicine (Internal Medicine) PhysicianM6241TX
2207L00000XAnesthesiology PhysicianM6241TX
3207L00000XAnesthesiology Physician220069MA

General Provider Information

NPI Number : 1093762783
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUZZANE JEAN KOO M.D.
Provider Business Mailing Address
First Line : 6720 BERTNER AVE
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2604
Country : US
Telephone Number : 832-355-2666
Fax Number :
Provider Business Practice Location Address
First Line : 6720 BERTNER AVE
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2604
Country : US
Telephone Number : 832-355-2666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2006
Last Update Date : 12/08/2025

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