Individual
SAM SUH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2120 N MACARTHUR BLVD, SUITE 100, IRVING, TX 75061-2225
(972) 438-4636
(214) 260-0953
Mailing address
2120 N MACARTHUR BLVD, SUITE 100, IRVING, TX 75061-2225
(972) 438-4636
(214) 260-0953
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00426
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86N348
BLUE CROSS
TX
Enumeration date
08/30/2006
Last updated
07/08/2007
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