# DR. SUSAN KATHLEEN DUBOIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1114091675
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | H6178 | TX | Yes |

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 06/10/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 147296102 | — | TX |
| 01 | — | 743009528 | GROUP TAX ID | — |
| 01 | — | 8U0684 | OLD BLUE CROSS \# | — |
| 01 | — | 8X7501 | NEW BLUE CROSS \# | — |