Blair, Susan
Blair, Susan is an individual health care provider with primary practice located at 11801 South Fwy Suite 338, Burleson TX 76028-7021. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Blair, Susan can be contacted via phone (817) 568-5485.Contact Information
Primary practice address
11801 South Fwy Suite 338
Burleson TX 76028-7021
Phone: (817) 568-5485
Fax: (817) 568-5434
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 230074 | Texas |
Profile Details
| NPI number | 1790883684 |
|---|---|
| LBN Legal business name | Blair, Susan |
| Credentials | FNP-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 21st, 2006 |
| Last updated | Nov 20th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790883684 | NPPES |
| Texas | MEDICAID | 103294803 | |
| Texas | MEDICAID | 103294801 |
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