Organization
OH SUSANNAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN L. MORELAND N/A (MEMBER)
(210) 386-2296
Entity
Organization
Contact information
Practice address
332 W SUNSET RD, SUITE 2B, SAN ANTONIO, TX 78209-1767
(210) 386-2296
(210) 828-3698
Mailing address
101 S SKIPPER DR, SAN ANTONIO, TX 78216-7446
(210) 386-2296
(210) 828-3698
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
N/A
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181471702
—
TX
Enumeration date
01/08/2009
Last updated
01/08/2009
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