Provider Demographics
NPI:1689452120
Name:SUAREZ, RO (FITNESS TRAINER)
Entity Type:Individual
Prefix:
First Name:RO
Middle Name:
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:FITNESS TRAINER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8203 MALAGO POINT DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2877
Mailing Address - Country:US
Mailing Address - Phone:832-443-6372
Mailing Address - Fax:
Practice Address - Street 1:19005 FM 529 RD STE 10F
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-0226
Practice Address - Country:US
Practice Address - Phone:832-443-6372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty