Provider Demographics
NPI:1508132754
Name:NOVAK, SUZANNE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:NOVAK
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 FLINTRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-4351
Mailing Address - Country:US
Mailing Address - Phone:512-327-7940
Mailing Address - Fax:512-327-7975
Practice Address - Street 1:1600 FLINTRIDGE RD
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-4351
Practice Address - Country:US
Practice Address - Phone:512-327-7940
Practice Address - Fax:512-327-7975
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9886207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX500045773OtherTEXAS CONTROLLED SUBSTANCES REGISTRATION
TXF9886OtherMEDICAL LICENSE
TXF9886OtherMEDICAL LICENSE