MEDICARE: DR. SUSAN R PAYBERAH M.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	207Q00000X	Family Medicine Physician	J9262	TX

General Provider Information

NPI Number	:	1578550539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN R PAYBERAH M.D.

Provider Business Mailing Address
First Line	:	5960 WEST PARKER ROAD, SUITE 278
Second Line	:	MAILBOX 335
City	:	PLANO
State	:	TX
Zip	:	75093-8102
Country	:	US
Telephone Number	:	972-981-7822
Fax Number	:

Provider Business Practice Location Address
First Line	:	3105 PLACID SPRINGS LN
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-3915
Country	:	US
Telephone Number	:	469-327-1281
Fax Number	:	469-312-8779

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	08/27/2025

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