Provider Demographics
NPI:1487854840
Name:ARENTZ, SUELLEN CANDICE (MD)
Entity type:Individual
Prefix:DR
First Name:SUELLEN
Middle Name:CANDICE
Last Name:ARENTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUELLEN
Other - Middle Name:CANDICE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:18400 KATY FWY
Mailing Address - Street 2:MEDICAL OFFICE BUILDING 1, SUITE 560
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-1286
Mailing Address - Country:US
Mailing Address - Phone:832-522-3240
Mailing Address - Fax:
Practice Address - Street 1:18400 KATY FWY
Practice Address - Street 2:MEDICAL OFFICE BUILDING 1, SUITE 560
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1286
Practice Address - Country:US
Practice Address - Phone:832-522-3240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0017648390200000X, 208600000X
TXN49152086X0206X, 208600000X
ARE-6061208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8GF774OtherBCBS
TX215252205Medicaid
TX476801ZSWDMedicare PIN
TX476801ZSVEMedicare PIN