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NPI Code Detail

MEDICARE: BEN L SUEOKA M.D.

MEDICARE: BEN L SUEOKA M.D.
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
12085R0204XVascular & Interventional Radiology PhysicianL8207TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00145467OTHERTXMEDICARE-RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134125305
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEN L SUEOKA M.D.
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number : 254-724-2111
Fax Number :
Provider Business Practice Location Address
First Line : 700 SCOTT AND WHITE DR
Second Line :
City : COLLEGE STATION
State : TX
Zip : 77845-6441
Country : US
Telephone Number : 979-207-0100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 05/09/2025

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Directions to “ BEN L SUEOKA M.D.” Practice Location

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