Individual
SUSAN LANDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
23461
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86449A
BCBS
TX
Enumeration date
06/22/2006
Last updated
07/08/2007
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