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Individual

SUSAN D JOHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
6431 FANNIN ST, HOUSTON, TX 77030-1501
(713) 500-7626
(713) 500-7639
Mailing address
6431 FANNIN ST # 2.130, HOUSTON, TX 77030-1501
(713) 500-7626
(713) 500-7639

Taxonomy

Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
G8435
TX
2085R0202X
Diagnostic Radiology Physician
Primary
G8435
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
138212902
CSHCN
TX
01
138212914
CSHCN
TX
05
138212917
TX
05
138212918
TX
01
82445R
BCBS
TX
Enumeration date
06/14/2006
Last updated
02/22/2022
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