MEDICARE: DR. SUSAN TRAN KLEMENS O.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
1	152W00000X	Optometrist	7961T	TX

General Provider Information

NPI Number	:	1215142211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN TRAN KLEMENS O.D.

Provider Business Mailing Address
First Line	:	23502 ENCHANTED PATH
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78260-4337
Country	:	US
Telephone Number	:	510-274-9985
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 VALLEY HI DR STE 204
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78227-4612
Country	:	US
Telephone Number	:	210-969-4080
Fax Number	:	210-969-4010

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

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	02/01/2024

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