Fernandes, Susan
Fernandes, Susan is an individual health care provider with primary practice located at 620 S Grove St Ste 105 , Marshall TX 75670-5295. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Fernandes, Susan can be contacted via phone (903) 935-9441.Contact Information
Primary practice address
620 S Grove St Ste 105
Marshall TX 75670-5295
Phone: (903) 935-9441
Fax: (903) 938-1246
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | S2579 | Texas |
Profile Details
| NPI number | 1104211275 |
|---|---|
| LBN Legal business name | Fernandes, Susan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 5th, 2015 |
| Last updated | Dec 1st, 2020 - about 6 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 | 1104211275 | NPPES |
| Texas | Other | S2579 | STATE LICENSE |
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