Healthcare Provider Details

I. General information

NPI: 1083666242
Provider Name (Legal Business Name): DAVID SUOMINEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 W 15TH ST
PLANO TX
75075-7738
US

IV. Provider business mailing address

1820 PRESTON PARK BLVD STE 1825
PLANO TX
75093-5215
US

V. Phone/Fax

Practice location:
  • Phone: 972-596-6800
  • Fax:
Mailing address:
  • Phone: 972-867-7862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberJ6752
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: