Individual
DR. SUSAN KATHLEEN DUBOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2901 MONTOPOLIS DR, AUSTIN, TX 78741-6411
(512) 978-9901
(512) 901-9765
Mailing address
2901 MONTOPOLIS DR, AUSTIN, TX 78741-6411
(512) 978-9901
(512) 901-9765
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
H6178
TX
Other
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 #
—
Enumeration date
11/17/2006
Last updated
06/10/2016
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