Provider Demographics
NPI:1972506467
Name:HYMAN, SUSAN MECHANIC (AUD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MECHANIC
Last Name:HYMAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2190 EASTEX FWY
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77703-4939
Mailing Address - Country:US
Mailing Address - Phone:409-832-0999
Mailing Address - Fax:409-832-0993
Practice Address - Street 1:2190 EASTEX FWY
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77703-4939
Practice Address - Country:US
Practice Address - Phone:409-832-0999
Practice Address - Fax:409-832-0993
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2024-02-26
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-23
Provider Licenses
StateLicense IDTaxonomies
TX50521231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX094583403Medicaid
00T33LMedicare PIN