Provider Demographics
NPI:1649394420
Name:JONES, SUSAN B (AUDIOLOGIST)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:B
Last Name:JONES
Suffix:
Gender:F
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 WALNUT HILL DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-5052
Mailing Address - Country:US
Mailing Address - Phone:903-291-6300
Mailing Address - Fax:903-291-6305
Practice Address - Street 1:912 WALNUT HILL DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5052
Practice Address - Country:US
Practice Address - Phone:903-291-6300
Practice Address - Fax:903-291-6305
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51099231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80529AOtherBCBS OF TEXAS
TX80529AOtherBCBS OF TEXAS