Provider Demographics
NPI:1972664910
Name:DAVIS, SUSAN (LST)
Entity Type:Individual
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First Name:SUSAN
Middle Name:
Last Name:DAVIS
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Gender:F
Credentials:LST
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Mailing Address - Street 1:908 SOUTHMORE AVE
Mailing Address - Street 2:STE 270
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77502-1134
Mailing Address - Country:US
Mailing Address - Phone:713-477-2283
Mailing Address - Fax:713-475-5986
Practice Address - Street 1:908 SOUTHMORE AVE
Practice Address - Street 2:STE 270
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502-1134
Practice Address - Country:US
Practice Address - Phone:713-477-2283
Practice Address - Fax:713-475-5986
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist