Individual
SUSAN W WEATHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
F5795
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104795301
—
TX
05
—
104795303
—
TX
05
—
104795305
—
TX
05
—
170160904
—
TX
01
—
8AM786
BCBS
TX
Enumeration date
06/12/2006
Last updated
12/03/2009
Update your record
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