Provider Demographics
NPI:1275536179
Name:SUTLER, DENISE WEATHERS (MD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:WEATHERS
Last Name:SUTLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28602 HOFFMAN SPRING LN
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-1664
Mailing Address - Country:US
Mailing Address - Phone:513-706-2555
Mailing Address - Fax:
Practice Address - Street 1:7600 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1906
Practice Address - Country:US
Practice Address - Phone:713-790-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35076975S207V00000X
TXQ9912207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0704238OtherUNITED HEALTHCARE
OH2336556Medicaid
OH160057637OtherMEDICARE RAILROAD
OH288088OtherAMERIGROUP
KY7100242570Medicaid
OH76975OtherHUMANA
OH000000270800OtherANTHEM
OH311575051042OtherCARESOURCE
OH3119396OtherAETNA
OH000000270800OtherANTHEM
OH311575051042OtherCARESOURCE
OH2336556Medicaid
OH3119396OtherAETNA