MEDICARE: SUZANNE MICHELLE TURNER 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	7975T	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7975T	OTHER	TX	OD LICENSE

General Provider Information

NPI Number	:	1508120338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE MICHELLE TURNER O.D.

Provider Business Mailing Address
First Line	:	2406 HUNTER ROAD
Second Line	:	102
City	:	SAN MARCOS
State	:	TX
Zip	:	78666
Country	:	US
Telephone Number	:	512-754-6161
Fax Number	:

Provider Business Practice Location Address
First Line	:	2406 HUNTER RD
Second Line	:
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-5255
Country	:	US
Telephone Number	:	512-754-6161
Fax Number	:

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

Provider Enumeration Date	:	06/26/2012
Last Update Date	:	07/21/2022

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