Provider Demographics
NPI:1780058032
Name:SUNIGA, DANIEL BENARD (RT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:BENARD
Last Name:SUNIGA
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 HOLLY HALL ST APT 345
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-3941
Mailing Address - Country:US
Mailing Address - Phone:979-418-1189
Mailing Address - Fax:
Practice Address - Street 1:2250 HOLLY HALL ST APT 345
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-3941
Practice Address - Country:US
Practice Address - Phone:979-418-1189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX546481247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist