Provider Demographics
NPI:1922180967
Name:PAYVAR, SUSAN NMI (PH D)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:NMI
Last Name:PAYVAR
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 VETERANS DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8942
Mailing Address - Country:US
Mailing Address - Phone:956-291-9000
Mailing Address - Fax:
Practice Address - Street 1:2601 VETERANS DRIVE
Practice Address - Street 2:PSYCHOLOGY SERVICE
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:956-291-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071004884103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist