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General NPI Number Information
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NPI Number | 1003747429
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Entity Type | Individual
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Provider Name | OMAR ALEJANDRO SUJO MD
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Gender | Male
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Dates
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Enumeration Date | 05/26/2026
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Last Update Date | 05/26/2026
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Provider Practice Location Address
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Address Line | 5016 S US HIGHWAY 75
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City | DENISON
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State | TX
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Zip | 75020-4584
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Country | US
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Telephone | 903-416-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 5016 S US HIGHWAY 75
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City | DENISON
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State | TX
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Zip | 75020-4584
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Country | US
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Telephone | 903-416-4001
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Fax | 903-416-4936
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QP0002X
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Taxonomy Name | Physician Nutrition Specialist (Family Medicine)
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License Number | BP10097583
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License Number State | TX
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