Gregg, Susan
Gregg, Susan is an individual health care provider with primary practice located at 1401 Pennsylvania Ave , Fort Worth TX 76104-2113. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cytopathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is her primary health care specialty. Gregg, Susan can be contacted via phone (817) 250-5630.Contact Information
Primary practice address
1401 Pennsylvania Ave
Fort Worth TX 76104-2113
Phone: (817) 250-5630
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cytopathology | 207ZC0500X | H4940 | Texas |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | H4940 | Texas |
Profile Details
| NPI number | 1184621518 |
|---|---|
| LBN Legal business name | Gregg, Susan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Mar 9th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184621518 | NPPES |
| Other | 1184621518 | NPI | |
| MEDICAID | 124825401 | NPI | |
| Other | 220018991 | NPI | |
| Other | 81P373 | NPI |
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