Provider Demographics
NPI:1255519385
Name:DANIEL SUEZ, M.D., ALLERGY, ASTHMA AND IMMUNOLOGY CLINIC, P.A.
Entity type:Organization
Organization Name:DANIEL SUEZ, M.D., ALLERGY, ASTHMA AND IMMUNOLOGY CLINIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-401-0545
Mailing Address - Street 1:1115 KINWEST PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063
Mailing Address - Country:US
Mailing Address - Phone:972-401-0545
Mailing Address - Fax:972-401-0614
Practice Address - Street 1:1115 KINWEST PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063
Practice Address - Country:US
Practice Address - Phone:972-401-0545
Practice Address - Fax:972-401-0614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1217207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158640601Medicaid
TX00404UMedicare PIN
TX8A1128Medicare UPIN
TX158640601Medicaid