MEDICARE: DR. SUSAN ELIZABETH SHAUGER 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	6257TG	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6257TG	OTHER	TX	TEXAS OPTOMETRY BOARD

General Provider Information

NPI Number	:	1881640944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN ELIZABETH SHAUGER O.D.

Provider Business Mailing Address
First Line	:	3419 EL SALIDO PKWY STE 100
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-5639
Country	:	US
Telephone Number	:	512-918-3937
Fax Number	:	512-918-2028

Provider Business Practice Location Address
First Line	:	3419 EL SALIDO PKWY STE 100
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-5634
Country	:	US
Telephone Number	:	512-918-3937
Fax Number	:	512-918-2028

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	03/07/2023

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