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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0895096-01
—
TX
01
—
180317300
DEPT OF LABOR
TX
Enumeration date
03/24/2010
Last updated
05/28/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us