Provider Demographics
NPI:1902830409
Name:STRATEN, SUSAN M (DO)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:M
Last Name:STRATEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:M
Other - Last Name:QUATRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2021 N MACARTHUR BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-2210
Mailing Address - Country:US
Mailing Address - Phone:972-253-2560
Mailing Address - Fax:972-253-4218
Practice Address - Street 1:2021 N MACARTHUR BLVD STE 115
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2210
Practice Address - Country:US
Practice Address - Phone:972-253-4315
Practice Address - Fax:972-253-2587
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ54902085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0485229-07Medicaid
TX0485229-07Medicaid
TX294901YSFZMedicare PIN