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Organization
SUSAN VAN DE WATER, MD, PA
Active
Organization
SUSAN VAN DE WATER, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN DEAN VAN DE WATER MD (PRESIDENT)
(432) 570-0373
Entity
Organization
Contact information
Practice address
1030 N GRANDVIEW AVE, ODESSA, TX 79761-3149
(432) 570-0373
(432) 687-3143
Mailing address
PO BOX 62227, MIDLAND, TX 79711-2227
(432) 570-0373
(432) 687-3143
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
H2869
TX
Other
Enumeration date
03/24/2010
Last updated
05/28/2013
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