Provider Demographics
NPI:1003818337
Name:MONDAY, SUZANNE E (MD)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:E
Last Name:MONDAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:E
Other - Last Name:MONDAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 8128
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75404-8128
Mailing Address - Country:US
Mailing Address - Phone:903-454-8111
Mailing Address - Fax:903-454-1680
Practice Address - Street 1:4101 WESLEY ST
Practice Address - Street 2:SUITE C
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-5635
Practice Address - Country:US
Practice Address - Phone:903-461-1874
Practice Address - Fax:903-454-1680
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9358207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8EY894OtherBCBS
TX285695701Medicaid
TXTXB111773OtherPTAN
TXG85165Medicare UPIN
TX038808402Medicaid