MEDICARE: MRS. SUZANNE NICOLE VERMA MAMS, CCA

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	229N00000X	Anaplastologist

General Provider Information

NPI Number	:	1356533939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUZANNE NICOLE VERMA MAMS, CCA

Provider Business Mailing Address
First Line	:	PO BOX 261684
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75026-1684
Country	:	US
Telephone Number	:	214-564-4886
Fax Number	:	469-409-6142

Provider Business Practice Location Address
First Line	:	7965 CUSTER RD STE 114
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-3155
Country	:	US
Telephone Number	:	972-696-9497
Fax Number	:	469-409-6142

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

Provider Enumeration Date	:	08/16/2007
Last Update Date	:	11/22/2019

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Directions to “ MRS. SUZANNE NICOLE VERMA MAMS, CCA” Practice Location

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