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1306009469

NPI Code Detail

MEDICARE: DR. SUSAN LYNN OVERSTREET MD

MEDICARE: DR. SUSAN LYNN OVERSTREET 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	207Q00000X	Family Medicine Physician	N8553	TX
2	207Q00000X	Family Medicine Physician	149438	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P01053620	OTHER	TX	RAILROAD MEDICARE

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306009469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN LYNN OVERSTREET MD

Provider Business Mailing Address
First Line	:	5730 EXECUTIVE DR STE 230
Second Line	:
City	:	CATONSVILLE
State	:	MD
Zip	:	21228-1762
Country	:	US
Telephone Number	:	972-232-8080
Fax Number	:

Provider Business Practice Location Address
First Line	:	8000 FRANKFORD RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-6894
Country	:	US
Telephone Number	:	972-232-8080
Fax Number	:	800-281-9558

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

Provider Enumeration Date	:	07/08/2008
Last Update Date	:	02/26/2026

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Directions to “ DR. SUSAN LYNN OVERSTREET MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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