Provider Demographics
NPI:1780904862
Name:BREIT-PEREZ, SUZANNE (GNP)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:BREIT-PEREZ
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:MARIE
Other - Last Name:BRIET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4699 CR 309
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:78947-9607
Mailing Address - Country:US
Mailing Address - Phone:512-657-5387
Mailing Address - Fax:512-273-5696
Practice Address - Street 1:4699 CR 309
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TX
Practice Address - Zip Code:78947-9607
Practice Address - Country:US
Practice Address - Phone:512-891-0056
Practice Address - Fax:512-891-0075
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX672389363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology