Provider Demographics
NPI:1083661110
Name:TROTTER, SUZANNE FOX (PT)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:FOX
Last Name:TROTTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5408 APACHE CREEK CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-6459
Mailing Address - Country:US
Mailing Address - Phone:512-791-4341
Mailing Address - Fax:
Practice Address - Street 1:1515 W 35TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-1495
Practice Address - Country:US
Practice Address - Phone:512-791-4341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1098705225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist