Provider Demographics
NPI:1083749790
Name:SURPRISE, JUANEE (DC)
Entity Type:Individual
Prefix:
First Name:JUANEE
Middle Name:
Last Name:SURPRISE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 EMERALD SOUND BLVD
Mailing Address - Street 2:
Mailing Address - City:OAK POINT
Mailing Address - State:TX
Mailing Address - Zip Code:75068-2236
Mailing Address - Country:US
Mailing Address - Phone:972-292-1434
Mailing Address - Fax:
Practice Address - Street 1:1100 DALLAS DR STE 122
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-5121
Practice Address - Country:US
Practice Address - Phone:940-566-0000
Practice Address - Fax:940-565-6655
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4769111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition