Healthcare Provider Details

I. General information

NPI: 1770516106
Provider Name (Legal Business Name): MONICA L. SUCHOFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 07/08/2007
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

Practice location:
  • Phone: 915-581-5557
  • Fax:
Mailing address:
  • Phone: 915-779-1716
  • Fax: 915-771-6558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License NumberH0858
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: