Provider Demographics
NPI:1659411742
Name:SUZANNE E MONDAY MD
Entity Type:Organization
Organization Name:SUZANNE E MONDAY MD
Other - Org Name:GREENVILLE HEALTHCARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEE
Authorized Official - Middle Name:
Authorized Official - Last Name:AYAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-454-8111
Mailing Address - Street 1:PO BOX 8128
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75404-8128
Mailing Address - Country:US
Mailing Address - Phone:903-454-8111
Mailing Address - Fax:903-886-9924
Practice Address - Street 1:1700 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:TX
Practice Address - Zip Code:75428-3034
Practice Address - Country:US
Practice Address - Phone:903-886-9900
Practice Address - Fax:903-886-9924
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEE G MCCRARY JR MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-07
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9358207Q00000X
TXJ6584207Q00000X
TX225319363LF0000X
TX660449363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDA2786OtherRAILROAD MEDICARE
TX163200202Medicaid
TX0087JYOtherBCBS OF TEXAS
TX00332VMedicare ID - Type Unspecified