Individual
SUSANA SOFIA FORTICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 772-0531
Mailing address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 772-0531
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
BP10080734
TX
Other
Enumeration date
05/20/2022
Last updated
05/20/2022
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