Provider Demographics
NPI:1124021498
Name:FANG-SUAREZ, TING (MD)
Entity Type:Individual
Prefix:DR
First Name:TING
Middle Name:
Last Name:FANG-SUAREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6565 WEST LOOP S
Mailing Address - Street 2:SUITE 650
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3500
Mailing Address - Country:US
Mailing Address - Phone:713-797-1010
Mailing Address - Fax:713-797-6200
Practice Address - Street 1:6565 WEST LOOP S
Practice Address - Street 2:SUITE 650
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3500
Practice Address - Country:US
Practice Address - Phone:713-797-1010
Practice Address - Fax:713-797-6200
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0163207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179423201Medicaid
TX105351403Medicaid
TX105351403Medicaid
TXG92011Medicare UPIN
TX8707K0Medicare ID - Type Unspecified
TX105351403Medicaid