Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | F6926 | TX |
NPI | 1083650386 |
---|---|
Provider Name | Dr. Suzanne Mcclure |
First Address | Dallas, TX 75391-1230 |
Second Address | Webster, TX 77598-4219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 24/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
132726401 | (05) | TX |
132726402 | (05) | TX |
132726403 | (05) | TX |
132726407 | (05) | TX |
132726408 | (05) | TX |
132726409 | (05) | TX |
8R1499 | BLUE CROSS OF TEXAS (01) | TX |
C19063 | (02) |