Provider Demographics
NPI:1003051731
Name:MANZI, SUZANNE MARIE (MD, FAAPMR)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:MARIE
Last Name:MANZI
Suffix:
Gender:F
Credentials:MD, FAAPMR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 649834
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75264-9834
Mailing Address - Country:US
Mailing Address - Phone:346-308-6741
Mailing Address - Fax:346-571-2189
Practice Address - Street 1:4126 SOUTHWEST FWY STE 1700
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7317
Practice Address - Country:US
Practice Address - Phone:346-217-1111
Practice Address - Fax:346-571-2189
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7457208100000X
NV13758208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX276616YQDVMedicare UPIN
NVE0627XMedicare PIN