Individual
SUSAN GAUDICHON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. AUDIOLOGIST
Contact information
Practice address
6811 AUSTIN CENTER BOULEVARD SUITE 300, ARC FAR WEST MEDICAL TOWER, AUSTIN, TX 78731-3166
(512) 346-8888
(512) 406-7321
Mailing address
4515 SETON CENTER PKWY, SUITE 215 - CREDENTIALING, AUSTIN, TX 78759-5290
(512) 231-5507
(512) 406-6216
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
50859
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
352791301
—
TX
05
—
352791302
—
TX
01
—
456686YKXV
MEDICARE TRAVIS COUNTY
TX
01
—
456686YKXY
MEDICARE ROT
TX
Enumeration date
09/16/2015
Last updated
03/01/2016
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