Provider Demographics
NPI:1346289444
Name:SUED, JAIME (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:
Last Name:SUED
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 1:1108 E KIKA DE LA GARZA ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-4256
Mailing Address - Country:US
Mailing Address - Phone:956-663-0006
Mailing Address - Fax:956-663-0050
Practice Address - Street 1:1108 E KIKA DE LA GARZA ST
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-4256
Practice Address - Country:US
Practice Address - Phone:956-663-0006
Practice Address - Fax:956-663-0050
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7108208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX043023302Medicaid
TX043023302Medicaid
TX8C1907Medicare ID - Type Unspecified