Susan Van de Water, MD, PA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

H2869 Issued in TX

Legal business name

SUSAN VAN DE WATER, MD, PA

Practice address

1030 N Grandview Ave
Odessa, TX 79761-3149

Phone

(432) 570-0373

Fax

(432) 687-3143

NPI assigned

Mar 24, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Susan Dean Van de Water, MD

Title

President

Phone

(432) 570-0373

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cheryl J Vallie, NP

  • Family Nurse Practitioner
  • Midland, TX
  • NPI 1417941410
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369699200000",
    "number": "1376867937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62227",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797112227",
            "telephone_number": "432-570-0373",
            "fax_number": "432-687-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 N GRANDVIEW AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797613149",
            "telephone_number": "432-570-0373",
            "fax_number": "432-687-3143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN VAN DE WATER, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-24",
        "last_updated": "2013-05-28",
        "status": "A",
        "authorized_official_last_name": "VAN DE WATER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "432-570-0373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "H2869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0895096-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "180317300",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suresh N Gadasalli M D P a
• Suresh N. Gadasalli,M.D.,P.a.
• Suresh N. Gadasalli,M.D.,P.a.
• Suresh Prasad MD PA
• Oam Suriyamont, PHARMD
• Sushruta Surgical Associates PLLC
• Douglas Swiney, CRNA
• John Swope, PA-C
• Synergy Physical Therapy of Odessa LP
• Chun Ho Szeto, M.D.

• Physical Medicine & Rehabilitation Physician in Odessa, TX
• Providers in Odessa, TX by specialty
• Physical Medicine & Rehabilitation Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.