Active NPI
Su Zan Carpenter, M.D.
- Family Medicine Physician
- Angleton, TX
National Provider Identifier
1649355363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G8040
- Practice address
- 1113 E Cedar St
Angleton, TX 77515-5836 - Phone
- (979) 849-5703
- Fax
- (979) 849-5705
- NPI assigned
- Oct 25, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G8040 | TX | Primary |
Addresses
Primary practice location
1113 E Cedar St
Angleton, TX 77515-5836
Mailing address
1113 E Cedar St
Angleton, TX 77515-5836
Phone (979) 849-5703
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 23, 2013 through Nov 23, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G8040 | TX | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649355363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1113 E CEDAR ST",
"city": "ANGLETON",
"state": "TX",
"postal_code": "775155836",
"telephone_number": "979-849-5703",
"fax_number": "979-849-5705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1113 E CEDAR ST",
"city": "ANGLETON",
"state": "TX",
"postal_code": "775155836",
"telephone_number": "979-849-5703",
"fax_number": "979-849-5705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARPENTER",
"first_name": "SU ZAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "G8040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Angleton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.