Provider Demographics
NPI:1003683087
Name:SUAREZ, BARRAGAN M (LCDC)
Entity Type:Individual
Prefix:
First Name:BARRAGAN
Middle Name:M
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13926 ASHDALE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-5990
Mailing Address - Country:US
Mailing Address - Phone:128-181-8180
Mailing Address - Fax:
Practice Address - Street 1:13926 ASHDALE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-5990
Practice Address - Country:US
Practice Address - Phone:128-181-8180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8503101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)