Provider Demographics
NPI:1366434524
Name:SUH, DAVEY P (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVEY
Middle Name:P
Last Name:SUH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:2281 OLYMPIA DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028
Mailing Address - Country:US
Mailing Address - Phone:972-899-2170
Mailing Address - Fax:972-899-2171
Practice Address - Street 1:2281 OLYMPIA DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028
Practice Address - Country:US
Practice Address - Phone:972-899-2170
Practice Address - Fax:972-899-2171
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1581213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8286623OtherBLUELINK
TX0092HDOtherBC/BS - GROUP
TX5509529OtherCIGNA
TX7238347OtherAETNA
TX1482929-01Medicaid
TX1482929-01Medicaid
TX7238347OtherAETNA
TX8286623OtherBLUELINK