Provider Demographics
NPI:1629189527
Name:TOWNLEY, SUSIE LF (PA)
Entity Type:Individual
Prefix:
First Name:SUSIE
Middle Name:LF
Last Name:TOWNLEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3721 WILLIAMS DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-2401
Mailing Address - Country:US
Mailing Address - Phone:512-869-7310
Mailing Address - Fax:512-869-2561
Practice Address - Street 1:3721 WILLIAMS DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-2401
Practice Address - Country:US
Practice Address - Phone:512-869-7310
Practice Address - Fax:512-869-2561
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA04914363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant