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NPI Code Detail

MEDICARE: DR. SUSAN V DOHERTY DPT

MEDICARE: DR. SUSAN V DOHERTY DPT
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 Therapist1274449TX

General Provider Information

NPI Number : 1255084471
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN V DOHERTY DPT
Provider Business Mailing Address
First Line : 11909 CHISEL RDG
Second Line :
City : PEARLAND
State : TX
Zip : 77584-3967
Country : US
Telephone Number : 281-685-3664
Fax Number :
Provider Business Practice Location Address
First Line : 3651 WESLAYAN ST STE 110
Second Line :
City : HOUSTON
State : TX
Zip : 77027-6638
Country : US
Telephone Number : 713-850-8472
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2022
Last Update Date : 01/28/2022

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Directions to “ DR. SUSAN V DOHERTY DPT” Practice Location

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