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NPI Code Detail

MEDICARE: STACY JOANA SUAREZ

MEDICARE:   STACY JOANA SUAREZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant216312TX

General Provider Information

NPI Number : 1922730126
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY JOANA SUAREZ
Provider Business Mailing Address
First Line : 5701 MAPLE AVE STE 100
Second Line :
City : DALLAS
State : TX
Zip : 75235-6596
Country : US
Telephone Number : 214-351-6600
Fax Number : 214-351-5046
Provider Business Practice Location Address
First Line : 5701 MAPLE AVE STE 100
Second Line :
City : DALLAS
State : TX
Zip : 75235-6596
Country : US
Telephone Number : 214-351-6600
Fax Number : 214-351-5046
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2022
Last Update Date : 06/27/2022

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Directions to “ STACY JOANA SUAREZ ” Practice Location

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