Doctor Name: | MRS. SUSAN YVONNE PELLETIER |
NPI Number: | 1629409198 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 101300 |
Business Practice Address: | 1600 Central Drive Suite 157 Bedford, TX - 76022 |
Business Phone Number: | 8172670909 |
Business Fax Number: | 8172831868 |
Mailing Address: | 1600 Central Drive, Suite 157 BEDFORD |
State: | TX |
Postal Code: | 76022 |
Phone Number: | 8172670909 |
Fax Number: | 8172831868 |
NPI Enumeration Date: | 12/09/2013 |
NPI Last Update Date: | 12/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 101300 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |