Doctor Name: | DR. SUSAN MOSES SHROPSHIRE |
NPI Number: | 1588906218 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | E9822 |
Business Practice Address: | 4812 Camp Bowie Blvd Suite B Fort Worth, TX - 761074121 |
Business Phone Number: | 8177325515 |
Business Fax Number: | 8177377271 |
Mailing Address: | 4812 Camp Bowie Blvd, Suite B FORT WORTH |
State: | TX |
Postal Code: | 761074121 |
Phone Number: | 8177325515 |
Fax Number: | 8177377271 |
NPI Enumeration Date: | 03/20/2013 |
NPI Last Update Date: | 03/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | E9822 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |