Provider Demographics
NPI:1578550539
Name:PAYBERAH, SUSAN R (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:R
Last Name:PAYBERAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUSAN
Other - Middle Name:REBECCA
Other - Last Name:PAYBERAH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5960 WEST PARKER ROAD, SUITE 278
Mailing Address - Street 2:MAILBOX 335
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8102
Mailing Address - Country:US
Mailing Address - Phone:972-981-7822
Mailing Address - Fax:
Practice Address - Street 1:3105 PLACID SPRINGS LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3915
Practice Address - Country:US
Practice Address - Phone:469-327-1281
Practice Address - Fax:469-312-8779
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9262207Q00000X
TXJ6292261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty