Provider Demographics
NPI:1396820528
Name:NEESE, SUSAN L (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:NEESE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1215 S COULTER ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1758
Mailing Address - Country:US
Mailing Address - Phone:806-677-2039
Mailing Address - Fax:806-677-2024
Practice Address - Street 1:1215 S COULTER ST
Practice Address - Street 2:SUITE 202
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1758
Practice Address - Country:US
Practice Address - Phone:806-677-2039
Practice Address - Fax:806-677-2024
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2013-02-12
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Provider Licenses
StateLicense IDTaxonomies
TXK2759207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG92365Medicare UPIN