Provider Demographics
NPI:1366539140
Name:SUGERMAN, SUSAN TUCKER (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:TUCKER
Last Name:SUGERMAN
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Gender:F
Credentials:MD, MPH
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Other - First Name:
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Mailing Address - Street 1:16980 DALLAS PARKWAY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252
Mailing Address - Country:US
Mailing Address - Phone:972-733-6565
Mailing Address - Fax:972-733-6564
Practice Address - Street 1:16980 DALLAS PARKWAY
Practice Address - Street 2:SUITE 204
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248
Practice Address - Country:US
Practice Address - Phone:972-733-6565
Practice Address - Fax:972-733-6564
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-02-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ0296208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine