Provider Demographics
NPI:1669470332
Name:SUAREZ, JOSE A (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:A
Last Name:SUAREZ
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 1:4316 23RD ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1812
Mailing Address - Country:US
Mailing Address - Phone:806-701-5858
Mailing Address - Fax:806-701-4184
Practice Address - Street 1:1655 MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79401
Practice Address - Country:US
Practice Address - Phone:806-701-5858
Practice Address - Fax:806-701-5799
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6189207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM202000166OtherPRESBYTERIAN COMMERCIAL
TX87928ZOtherHMO BLUE
TX175918501Medicaid
NM46685367Medicaid
TXS0140833OtherDPS
OK200060860AMedicaid
TX144533100OtherFIRSTCARE COMMERCIAL
TX175918502Medicaid
NM202000166Medicaid
TX8S5201OtherBC/BS
TX144533101Medicaid
TX144533101Medicaid
NM202000166OtherPRESBYTERIAN COMMERCIAL
NM202000166Medicaid
TX175918501Medicaid