Individual
SUSANNA L GIROCCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA05092
TX
363AS0400X
Surgical Physician Assistant
Primary
PA05092
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191910202
—
TX
05
—
191910205 (MDACC)
—
TX
01
—
8526NU
BCBS (MDACC)
TX
01
—
8Y1250
BCBS
TX
01
—
8Y8344
BCBSTX
TX
Enumeration date
11/14/2006
Last updated
03/14/2016
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