Provider Demographics
NPI:1295043305
Name:FOX, SUSAN E (NP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:E
Last Name:FOX
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11920 ASTORIA BLVD
Mailing Address - Street 2:STE 400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089
Mailing Address - Country:US
Mailing Address - Phone:281-484-0996
Mailing Address - Fax:
Practice Address - Street 1:11920 ASTORIA BLVD
Practice Address - Street 2:STE 400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089
Practice Address - Country:US
Practice Address - Phone:281-484-0996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX520340363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health