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General NPI Number Information
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NPI Number | 1821186545
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Entity Type | Organization
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Legal Business Name | THOMAS S SUDELA MD PA
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 2504 RIDGE RD STE 201
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City | ROCKWALL
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State | TX
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Zip | 75087-2571
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Country | US
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Telephone | 972-722-0404
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Fax | 972-722-7082
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Provider Business Mailing Address
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Address Line | PO BOX 944
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City | ROWLETT
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State | TX
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Zip | 75030-0944
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Country | US
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Telephone | 214-269-3326
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Fax | 214-269-3327
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MR. JANA MORGAN
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Credential |
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Telephone | 214-269-3326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 203BX0001X
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License Number State | TX
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