Provider Demographics
NPI:1104025337
Name:ONISKO, NANCY SUZANNE (DO)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:SUZANNE
Last Name:ONISKO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:MC 8890
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-8890
Mailing Address - Country:US
Mailing Address - Phone:623-261-8154
Mailing Address - Fax:
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:MC 8890
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-8890
Practice Address - Country:US
Practice Address - Phone:623-261-8154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7685207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1104025337Medicaid
CABT591ZMedicare PIN