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Individual

SUZETTE L. ELDRED

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHCNP

Contact information

Practice address
9202 ELAM RD, SOUTHEAST DALLAS WOMEN'S HEALTH CENTER, DALLAS, TX 75217-4151
(214) 266-1500
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
619003
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
061245902
TX
05
061246708
TX
05
061246709
TX
05
061246710
TX
05
061246711
TX
05
061246712
TX
05
061246713
TX
05
061246714
TX
05
061246715
TX
05
061246716
TX
05
061246717
TX
05
061246718
TX
01
8Y3787
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/28/2006
Last updated
04/16/2009
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