Provider Demographics
NPI:1831138221
Name:ESCUDIER, SUSAN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MARIE
Last Name:ESCUDIER
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:7515 MAIN ST
Practice Address - Street 2:SUITE 740
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4519
Practice Address - Country:US
Practice Address - Phone:713-795-0202
Practice Address - Fax:713-799-8290
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0332207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135805303Medicaid
TX135805310Medicaid
TXBR1435OtherBLUE CROSS OF TEXAS
TX135805301Medicaid
TX135805309Medicaid
TX135805311Medicaid
TX135805313Medicaid
TX8G6412Medicare PIN
TX830007663Medicare PIN
TXBR1435OtherBLUE CROSS OF TEXAS
TX135805313Medicaid
TX87754KMedicare PIN
TX135805303Medicaid
TX135805301Medicaid