Suzanne Emerita Anderson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4650TG Issued in TX

Practice address

6301 NW Loop 410
Sears Building
San Antonio, TX 78238-3824

Phone

(210) 682-3773

Fax

(210) 682-3773

NPI assigned

Aug 10, 2006

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 names 1

• Dr. Suzanne Nadine Emerita Gentles Former name

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982615449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8010 DOVE FLIGHT",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78250",
            "telephone_number": "210-682-3773",
            "fax_number": "210-682-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 NW LOOP 410",
            "address_2": "SEARS BUILDING",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782383824",
            "telephone_number": "210-682-3773",
            "fax_number": "210-682-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SUZANNE",
        "middle_name": "EMERITA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4650TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "GENTLES",
            "middle_name": "NADINE EMERITA",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Elizabeth Anderson, RN
• Sherry Teresa Anderson, AGACNP
• Simone Anderson, CERTIFIED PHLEBOTOMI
• Stephanie Lee Anderson, MD
• Stephanie Lynn Anderson
• Taryn Marie Anderson, LMT
• Terri Lynn Anderson, CRNA
• Trey Nicholas Anderson, COTA/L
• Yolanda Anderson
• Bonnie K Anderson,

• Optometrist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Optometrist in Texas

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.