Provider Demographics
NPI:1902808801
Name:ZUSPANN, JUDITH R (PA C)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:R
Last Name:ZUSPANN
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7771 E HWY 153
Mailing Address - Street 2:
Mailing Address - City:WINTERS
Mailing Address - State:TX
Mailing Address - Zip Code:79567
Mailing Address - Country:US
Mailing Address - Phone:325-754-1317
Mailing Address - Fax:325-754-1208
Practice Address - Street 1:7771 E HWY 153
Practice Address - Street 2:
Practice Address - City:WINTERS
Practice Address - State:TX
Practice Address - Zip Code:79567
Practice Address - Country:US
Practice Address - Phone:325-754-1317
Practice Address - Fax:325-754-1208
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03691363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical