Provider Demographics
NPI:1043931041
Name:SUHEY, AUDRIANA (NP)
Entity Type:Individual
Prefix:
First Name:AUDRIANA
Middle Name:
Last Name:SUHEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18333 EGRET BAY BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3239
Mailing Address - Country:US
Mailing Address - Phone:281-332-3001
Mailing Address - Fax:
Practice Address - Street 1:110 E MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4301
Practice Address - Country:US
Practice Address - Phone:832-224-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1087131363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX455414901Medicaid
TX8TL743OtherBCBS
TX455414902Medicaid