MEDICARE: SUZANNE PITTS MD

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
1	207L00000X	Anesthesiology Physician	G5487	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114940871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE PITTS MD

Provider Business Mailing Address
First Line	:	28235 EQUESTRIAN
Second Line	:
City	:	FAIR OAKS RANCH
State	:	TX
Zip	:	78015-4656
Country	:	US
Telephone Number	:	210-698-3144
Fax Number	:

Provider Business Practice Location Address
First Line	:	28235 EQUESTRIAN
Second Line	:
City	:	FAIR OAKS RANCH
State	:	TX
Zip	:	78015-4656
Country	:	US
Telephone Number	:	210-698-3144
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	04/01/2020

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