Provider Demographics
NPI:1053425322
Name:SUGGS, JOHN ALLEN (PT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ALLEN
Last Name:SUGGS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 TEAL DR
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-4025
Mailing Address - Country:US
Mailing Address - Phone:281-534-2948
Mailing Address - Fax:
Practice Address - Street 1:6501 MEMORIAL DRIVE
Practice Address - Street 2:STE A
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591
Practice Address - Country:US
Practice Address - Phone:409-935-1393
Practice Address - Fax:409-935-3844
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1032605225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T6163OtherBCBS PROVIDER NUMBER