MEDICARE: SUSAN E BACKES 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	2084P0800X	Psychiatry Physician	62635	TX

General Provider Information

NPI Number	:	1972504975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN E BACKES MD

Provider Business Mailing Address
First Line	:	4550 POST OAK PLACE DR
Second Line	:	STE 252
City	:	HOUSTON
State	:	TX
Zip	:	77027-3165
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4550 POST OAK PLACE DR
Second Line	:	STE 252
City	:	HOUSTON
State	:	TX
Zip	:	77027-3165
Country	:	US
Telephone Number	:	713-621-4950
Fax Number	:

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	11/04/2008

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