MEDICARE: SUZANNE MARIE DOWNING PT, 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
1	225100000X	Physical Therapist	1218643	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	TXB165071	OTHER	TX	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	12430579	OTHER		CAQH

General Provider Information

NPI Number	:	1457606246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE MARIE DOWNING PT, DPT

Provider Business Mailing Address
First Line	:	7718 WOOD HOLLOW DR
Second Line	:	SUITE 105
City	:	AUSTIN
State	:	TX
Zip	:	78731-1648
Country	:	US
Telephone Number	:	512-795-0053
Fax Number	:	512-795-0043

Provider Business Practice Location Address
First Line	:	7718 WOOD HOLLOW DR
Second Line	:	SUITE 105
City	:	AUSTIN
State	:	TX
Zip	:	78731-1648
Country	:	US
Telephone Number	:	512-795-0053
Fax Number	:	512-795-0043

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

Provider Enumeration Date	:	07/17/2012
Last Update Date	:	06/26/2013

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