Provider Demographics
NPI:1154309516
Name:SUKIN, STEVEN WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WAYNE
Last Name:SUKIN
Suffix:
Gender:M
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:506 GRAHAM DR
Practice Address - Street 2:STE 150
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-3366
Practice Address - Country:US
Practice Address - Phone:281-351-5174
Practice Address - Fax:281-351-5172
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3491208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00464640OtherMEDICARE RAILROAD ID
TXP00998374OtherRAILROAD MEDICARE
TX742211363OtherTAX ID
TX8F8654Medicare PIN
TX8L0611Medicare PIN