Provider Demographics
NPI:1740560267
Name:SUAREZ, SIERRA VOGT (OD)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:VOGT
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SIERRA
Other - Middle Name:NICOLE
Other - Last Name:VOGT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:5926 W PARKER RD STE 400
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6418
Mailing Address - Country:US
Mailing Address - Phone:972-599-2020
Mailing Address - Fax:
Practice Address - Street 1:5926 W PARKER RD STE 400
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6418
Practice Address - Country:US
Practice Address - Phone:972-599-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1658152W00000X
TX9942TG152W00000X
NJ27OM00120200152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA78790281Medicare UPIN