Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | K9123 | TX |
N | 208600000X | Surgeon | K9123 | TX |
Y | 2086S0102X | Surgical Critical Care | K9123 | TX |
NPI | 1174620462 |
---|---|
Provider Name | Susan F. Mclean |
First Address | El Paso, TX 79905-1613 |
Second Address | El Paso, TX 79905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 13/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
118064802 | (05) | TX |
83051K | BCBS OF TEXAS (01) | TX |
G07366 | (02) | TX |