Provider Demographics
NPI:1487638946
Name:ALLEN, SUSAN (DO)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:SAVELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:6838 ALAMO PKWY STE 5
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-6567
Mailing Address - Country:US
Mailing Address - Phone:210-233-7000
Mailing Address - Fax:210-438-9064
Practice Address - Street 1:6838 ALAMO PKWY STE 5
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-6567
Practice Address - Country:US
Practice Address - Phone:210-233-7000
Practice Address - Fax:210-438-9064
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8436207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OTH000Medicare UPIN