Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | H1217 | TX |
NPI | 1255312773 |
---|---|
Provider Name | Dr. Daniel Suez |
First Address | Irving, TX 75063 |
Second Address | Irving, TX 75063 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4500906958 | CLEA # (01) | |
B26769 | (02) |