| Doctor Name: | SUSAN WILLIG FAN |
| NPI Number: | 1124044995 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | H7012 |
| Business Practice Address: | 2800 Garth Rd Baytown, TX - 775213947 |
| Business Phone Number: | 2814273700 |
| Business Fax Number: | |
| Mailing Address: | 319 Hawthorne St, HOUSTON |
| State: | TX |
| Postal Code: | 770064007 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/14/2006 |
| NPI Last Update Date: | 01/05/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | H7012 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |