MEDICARE: SUSAN L SWANSON 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	207W00000X	Ophthalmology Physician	H4440	TX

General Provider Information

NPI Number	:	1942372339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN L SWANSON MD

Provider Business Mailing Address
First Line	:	6131 LUTHER LN
Second Line	:	SUITE 216
City	:	DALLAS
State	:	TX
Zip	:	75225-6223
Country	:	US
Telephone Number	:	214-987-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	6131 LUTHER LN
Second Line	:	SUITE 216
City	:	DALLAS
State	:	TX
Zip	:	75225-6223
Country	:	US
Telephone Number	:	214-987-2020
Fax Number	:

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

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	11/10/2010

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