MEDICARE: SUSAN SI

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	103K00000X	Behavior Analyst	9579	TX

General Provider Information

NPI Number	:	1972235810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN SI

Provider Business Mailing Address
First Line	:	19255 PARK ROW STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-7310
Country	:	US
Telephone Number	:	346-333-2794
Fax Number	:

Provider Business Practice Location Address
First Line	:	19255 PARK ROW STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-7310
Country	:	US
Telephone Number	:	346-333-2794
Fax Number	:

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

Provider Enumeration Date	:	06/29/2022
Last Update Date	:	01/02/2026

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Directions to “ SUSAN SI ” Practice Location

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