Provider Demographics
NPI:1720403066
Name:KABZINSKI, SUZANNE CULLERS (PA-C)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:CULLERS
Last Name:KABZINSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28326 STERLING OAK DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4935
Mailing Address - Country:US
Mailing Address - Phone:407-908-9662
Mailing Address - Fax:
Practice Address - Street 1:508 MEDICAL CENTER BLVD STE 350
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2845
Practice Address - Country:US
Practice Address - Phone:936-760-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
TXPA08867207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant