Provider Demographics
NPI:1851300214
Name:BORNSTEIN, SUE SCHER (MD)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:SCHER
Last Name:BORNSTEIN
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 1:3111 BEVERLY DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-2922
Mailing Address - Country:US
Mailing Address - Phone:214-522-4767
Mailing Address - Fax:214-219-5881
Practice Address - Street 1:3111 BEVERLY DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-2922
Practice Address - Country:US
Practice Address - Phone:214-522-4767
Practice Address - Fax:214-219-5881
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3997207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0084NGOtherBCBS
TX0084NGOtherBCBS
TX612283Medicare ID - Type Unspecified