Provider Demographics
NPI:1235551003
Name:ENRIQUEZ, SUZY
Entity Type:Individual
Prefix:
First Name:SUZY
Middle Name:
Last Name:ENRIQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11901 W PARMER LN
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7651
Mailing Address - Country:US
Mailing Address - Phone:512-652-0050
Mailing Address - Fax:512-997-9092
Practice Address - Street 1:11901 W PARMER LN
Practice Address - Street 2:SUITE 300
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7651
Practice Address - Country:US
Practice Address - Phone:512-652-0050
Practice Address - Fax:512-997-9092
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other