Provider Demographics
NPI:1851875306
Name:JUDEH, ZAKIEH SUZANNE (HIS)
Entity Type:Individual
Prefix:MS
First Name:ZAKIEH
Middle Name:SUZANNE
Last Name:JUDEH
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 BROWN TRAIL
Mailing Address - Street 2:#Q
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4135
Mailing Address - Country:US
Mailing Address - Phone:817-656-8600
Mailing Address - Fax:817-656-4030
Practice Address - Street 1:2905 BROWN TRAIL
Practice Address - Street 2:#Q
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4135
Practice Address - Country:US
Practice Address - Phone:817-656-8600
Practice Address - Fax:817-656-4030
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80806237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist