Provider Demographics
NPI:1487113411
Name:SWANNEGAN, SUSANNA CHREE
Entity type:Individual
Prefix:
First Name:SUSANNA
Middle Name:CHREE
Last Name:SWANNEGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5413 DOOLITTLE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77033-2708
Mailing Address - Country:US
Mailing Address - Phone:346-243-2447
Mailing Address - Fax:
Practice Address - Street 1:77 SUGAR CREEK CENTER BLVD STE 600
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3688
Practice Address - Country:US
Practice Address - Phone:346-243-2447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-19
Last Update Date:2020-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health