Healthcare Provider Details

I. General information

NPI: 1376545368
Provider Name (Legal Business Name): RICHARD A. SUSS, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W ARBROOK BLVD SUITE 300
ARLINGTON TX
76015-4327
US

IV. Provider business mailing address

5938 DESCO DR
DALLAS TX
75225-1603
US

V. Phone/Fax

Practice location:
  • Phone: 817-417-4544
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD A. SUSS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 214-363-5690