Provider Demographics
NPI:1851594071
Name:FEAGIN, SUSANNAH (DDS)
Entity Type:Individual
Prefix:
First Name:SUSANNAH
Middle Name:
Last Name:FEAGIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 KIRBY DR
Mailing Address - Street 2:SUITE 1116
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3925
Mailing Address - Country:US
Mailing Address - Phone:713-526-8989
Mailing Address - Fax:713-522-2664
Practice Address - Street 1:3701 KIRBY DR
Practice Address - Street 2:SUITE 1116
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3925
Practice Address - Country:US
Practice Address - Phone:713-526-8989
Practice Address - Fax:713-522-2664
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16262122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist