Active NPI
Susan Brister, MD
- Internal Medicine Physician
- Pflugerville, TX
National Provider Identifier
1033178751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- L9111
- Practice address
- 2700 Pecan St W
Ste 102
Pflugerville, TX 78660-3199 - Phone
- (512) 421-3750
- Fax
- (512) 421-3751
- NPI assigned
- Mar 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | L9111 | TX | Primary |
Addresses
Primary practice location
2700 Pecan St W
Ste 102
Pflugerville, TX 78660-3199
Mailing address
2700 Pecan St W
Ste 102
Pflugerville, TX 78660-3199
Phone (512) 421-3750
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 314182YLPS | Other | TX | WELLMED PTAN |
| 1703035-01 | Medicaid | TX | |
| P00164042 | Other | TX | RR/MEDICARE |
| 170303504 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- susan.brister@wellmed.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480636800000",
"number": "1033178751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 PECAN ST W",
"address_2": "STE 102",
"city": "PFLUGERVILLE",
"state": "TX",
"postal_code": "786603199",
"telephone_number": "512-421-3750",
"fax_number": "512-421-3751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 PECAN ST W",
"address_2": "STE 102",
"city": "PFLUGERVILLE",
"state": "TX",
"postal_code": "786603199",
"telephone_number": "512-421-3750",
"fax_number": "512-421-3751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRISTER",
"first_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-21",
"last_updated": "2016-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "L9111",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMED PTAN",
"identifier": "314182YLPS",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1703035-01",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR/MEDICARE",
"identifier": "P00164042",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "170303504",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pflugerville, TX
- Brenda R. Gentry DDS, PA
- Lindsay K Brettmann, MD
- Megan Long Briggs, SPEECH LANGUAGE PATH
- Bright Life Adult Day Supportive Services, LLC
- Bright Smiles Dental PC
- Broadmoor Healthcare Holdings, LLC
- Jenny Garcia Brockway, M.S., NCC, LPC
- Jinnie A Bruce, MD
- Brenee Brunson
- Brush32 Dental of Pflugerville PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.