Provider Demographics
NPI:1649419144
Name:PELZER, SUSAN G (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:G
Last Name:PELZER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 JACKSON KELLER RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-7118
Mailing Address - Country:US
Mailing Address - Phone:210-341-3191
Mailing Address - Fax:210-341-3863
Practice Address - Street 1:506 JACKSON KELLER RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-7118
Practice Address - Country:US
Practice Address - Phone:210-341-3191
Practice Address - Fax:210-341-3863
Is Sole Proprietor?:No
Enumeration Date:2009-02-07
Last Update Date:2009-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15420103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist