Provider Demographics
NPI:1790975910
Name:CROW, SUSAN WEISER (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:WEISER
Last Name:CROW
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 1:5560 INDEPENDENCE PKWY
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-4600
Mailing Address - Country:US
Mailing Address - Phone:214-389-8801
Mailing Address - Fax:214-389-8802
Practice Address - Street 1:5560 INDEPENDENCE PKWY
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-4600
Practice Address - Country:US
Practice Address - Phone:214-389-8801
Practice Address - Fax:214-389-8802
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9090208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics