Individual
DR. SUSAN G MOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
900 W MAGNOLIA AVE, STE 100, FORT WORTH, TX 76104-8517
(817) 870-7300
(817) 335-9529
Mailing address
PO BOX 35629, DALLAS, TX 75235-0629
(214) 424-2200
(214) 231-2159
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
H2624
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113878602
AETNA
—
05
—
113878602
—
TX
01
—
8GF863
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/02/2005
Last updated
12/20/2016
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