Healthcare Provider Details

I. General information

NPI: 1902545379
Provider Name (Legal Business Name): MARI CARLA SUAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2022
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14606 HALF CIRCLE ST
SPLENDORA TX
77372-4326
US

IV. Provider business mailing address

14606 HALF CIRCLE ST
SPLENDORA TX
77372-4326
US

V. Phone/Fax

Practice location:
  • Phone: 832-683-7976
  • Fax:
Mailing address:
  • Phone: 832-683-7976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: