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Individual

SUSAN WOOTTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
6410 FANNIN ST, 500, HOUSTON, TX 77030-3000
(832) 325-7111
(713) 512-2227
Mailing address
PO BOX 201088, HOUSTON, TX 77216-1088
(713) 500-3500

Taxonomy

Speciality
Code
Description
License number
State
2080P0208X
Pediatric Infectious Diseases Physician
0101059072
VA
2080P0208X
Pediatric Infectious Diseases Physician
Primary
M8437
TX
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
192014201
TX
01
192014202
CSHCN
TX
01
8X7055
BCBS
TX
Enumeration date
08/15/2007
Last updated
08/14/2008
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