MEDICARE: SUSAN C TORRIE 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	208000000X	Pediatrics Physician	J5653	TX

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	140620100	OTHER	TX	FIRSTCARE PIN
3	5076004	OTHER	TX	AETNA PIN
4	854435	OTHER	TX	FIRSTHEALTH PIN
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	TORSF86781	OTHER	TX	CCHIP PIN
7	1284012	OTHER	TX	UHC PIN
8	3444098	OTHER	TX	CIGNA PIN
9	1750369203	OTHER		GRP NPI NUMBER
10	86462G	OTHER	TX	BCBSTX IND PIN
11	00U87Z	OTHER	TX	BCBSTX GRP PIN

General Provider Information

NPI Number	:	1578643417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN C TORRIE MD

Provider Business Mailing Address
First Line	:	PO BOX 99371
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76199-0371
Country	:	US
Telephone Number	:	682-885-1855
Fax Number	:	682-885-7347

Provider Business Practice Location Address
First Line	:	3201 TEASLEY LN
Second Line	:	STE 102
City	:	DENTON
State	:	TX
Zip	:	76210-8302
Country	:	US
Telephone Number	:	940-565-1510
Fax Number	:	940-243-0607

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

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	05/19/2016

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Directions to “ SUSAN C TORRIE MD” Practice Location

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