MEDICARE: DR. JORGE ANTONIO SUAREZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	J2359	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	00K84C	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1093846107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORGE ANTONIO SUAREZ MD

Provider Business Mailing Address
First Line	:	8090 WESTHEIMER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-2902
Country	:	US
Telephone Number	:	713-782-1717
Fax Number	:	713-782-2151

Provider Business Practice Location Address
First Line	:	8090 WESTHEIMER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-2902
Country	:	US
Telephone Number	:	713-782-1717
Fax Number	:	713-782-2151

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	08/25/2008

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