Provider Demographics
NPI:1144250879
Name:BACHMAN, SUZANNE L (OD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:L
Last Name:BACHMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3960 FM 2181 STE 100
Mailing Address - Street 2:
Mailing Address - City:HICKORY CREEK
Mailing Address - State:TX
Mailing Address - Zip Code:75065-4248
Mailing Address - Country:US
Mailing Address - Phone:940-497-4971
Mailing Address - Fax:940-497-4981
Practice Address - Street 1:3960 FM 2181
Practice Address - Street 2:
Practice Address - City:HICKORY CREEK
Practice Address - State:TX
Practice Address - Zip Code:75065-4248
Practice Address - Country:US
Practice Address - Phone:940-497-4971
Practice Address - Fax:940-497-4981
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05935-TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX214203603Medicaid
TX214203601Medicaid
TX8K5417Medicare PIN