Healthcare Provider Details
I. General information
NPI: 1235162660
Provider Name (Legal Business Name): MONICA SUCHOFF, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
840 E REDD RD BLDG. 3
EL PASO TX
79912-7221
US
IV. Provider business mailing address
5959 GATEWAY BLVD W STE. 120
EL PASO TX
79925-3331
US
V. Phone/Fax
- Phone: 915-581-5557
- Fax: 915-225-6443
- Phone: 915-779-1716
- Fax: 915-771-6558
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0006X |
| Taxonomy | Developmental - Behavioral Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MONICA
L.
SU;CHOFF
Title or Position: OWNER/PHYSICIAN
Credential: M.D.
Phone: 915-581-5557