Provider Demographics
NPI:1457606246
Name:DOWNING, SUZANNE MARIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MARIE
Last Name:DOWNING
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7718 WOOD HOLLOW DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1648
Mailing Address - Country:US
Mailing Address - Phone:512-795-0053
Mailing Address - Fax:512-795-0043
Practice Address - Street 1:7718 WOOD HOLLOW DR
Practice Address - Street 2:SUITE 105
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-1648
Practice Address - Country:US
Practice Address - Phone:512-795-0053
Practice Address - Fax:512-795-0043
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1218643225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB165071OtherMEDICARE PTAN
12430579OtherCAQH