Provider Demographics
NPI:1578643417
Name:TORRIE, SUSAN C (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:C
Last Name:TORRIE
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:PO BOX 99371
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0371
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-7347
Practice Address - Street 1:3201 TEASLEY LN
Practice Address - Street 2:STE 102
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-8302
Practice Address - Country:US
Practice Address - Phone:940-565-1510
Practice Address - Fax:940-243-0607
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5653208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137345802Medicaid
TX140620100OtherFIRSTCARE PIN
TX5076004OtherAETNA PIN
TX854435OtherFIRSTHEALTH PIN
TX124921103Medicaid
TXTORSF86781OtherCCHIP PIN
TX1284012OtherUHC PIN
TX3444098OtherCIGNA PIN
1750369203OtherGRP NPI NUMBER
TX86462GOtherBCBSTX IND PIN
TX00U87ZOtherBCBSTX GRP PIN
TX1284012OtherUHC PIN
TXTORSF86781OtherCCHIP PIN
F86781Medicare UPIN