Suzanne D Black, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

H2250 Issued in TX

Practice address

2714 Osler Blvd
Bryan, TX 77802-2517

Phone

(979) 776-7788

Fax

(797) 776-0848

NPI assigned

Jun 13, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Emerelli, PLLC

  • Physical Therapist
  • Bryan, TX
  • NPI 1336960301
  NPD (past)
• Family Practice Foundation of the Brazos Valley

  • Family Medicine Physician
  • Bryan, TX
  • NPI 1578573531
  NPD (past)
• Sports, Back & Pain Mangement Clinic

  • Orthopedic Physical Therapist
  • Bryan, TX
  • NPI 1275786469
  NPD (past)
• Texas a&M University System Health Science Center

  • Family Medicine Physician
  • Bryan, TX
  • NPI 1063699312
  NPD (past)
• Texas a&M University System Health Science Center

  • Rural Health Clinic/Center
  • Navasota, TX
  • NPI 1558140004
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1720082167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2714 OSLER BLVD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022517",
            "telephone_number": "979-776-7788",
            "fax_number": "797-776-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2714 OSLER BLVD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022517",
            "telephone_number": "979-776-7788",
            "fax_number": "797-776-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "SUZANNE",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H2250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133493001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "00T34F",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133493007",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Russel Kevin Biles, M.D.
• Bio-Medical Applications of Texas Inc
• William R. Birdwell, DDS
• Christina Birgen, LPC, LMFT-A
• L. Diane Black, MA, LMFT
• Elizabeth Renee Blackwell, PT
• Katherine E Blalock, M.D.
• Stacie L Blankenship
• Angie Bleike, LPC
• Sophia Blossom, LPC

• Family Medicine Physician in Bryan, TX
• Providers in Bryan, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.