MEDICARE: SUSAN PORTNOY EPNER, M.D., P.A.

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	2084N0400X	Neurology Physician

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	0066TE	OTHER	TX	BCBS GROUP
3	8CG786	OTHER	TX	BCBS INDIVIDUAL

General Provider Information

NPI Number	:	1558503839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUSAN PORTNOY EPNER, M.D., P.A.

Provider Business Mailing Address
First Line	:	4903 GOLDEN QUAIL
Second Line	:	SUITE 104
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1584
Country	:	US
Telephone Number	:	210-877-2727
Fax Number	:	210-877-0267

Provider Business Practice Location Address
First Line	:	4903 GOLDEN QUAIL
Second Line	:	SUITE 104
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1584
Country	:	US
Telephone Number	:	210-877-2727
Fax Number	:	210-877-0267

Authorized Official
Title or Position	:	OWNER
Name	:	SUSAN PORTNOY EPNER
Credential	:	M.D.
Telephone Number	:	210-497-0494

Provider Enumeration Date	:	04/01/2009
Last Update Date	:	04/07/2010

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Directions to “SUSAN PORTNOY EPNER, M.D., P.A. ” Practice Location

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