Provider Demographics
NPI:1437656568
Name:SUAREZ, ANNA LUCIA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:LUCIA
Last Name:SUAREZ
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 1:3220 HOUSTON ST APT 6
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-3750
Mailing Address - Country:US
Mailing Address - Phone:361-396-2619
Mailing Address - Fax:
Practice Address - Street 1:800 N SHORELINE BLVD STE 700
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78401-3771
Practice Address - Country:US
Practice Address - Phone:361-937-7887
Practice Address - Fax:877-589-4711
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104725164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse