Provider Demographics
NPI:1053530824
Name:DOMMAR, SUSANA MARIA (CHIROPRACTOR)
Entity type:Individual
Prefix:DR
First Name:SUSANA
Middle Name:MARIA
Last Name:DOMMAR
Suffix:
Gender:F
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:DELIDA
Other - Middle Name:MARIA
Other - Last Name:MORGADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 266535
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77207-6535
Mailing Address - Country:US
Mailing Address - Phone:713-645-0546
Mailing Address - Fax:713-242-0242
Practice Address - Street 1:7575 GULF FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017
Practice Address - Country:US
Practice Address - Phone:713-645-0546
Practice Address - Fax:713-645-0546
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8161111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist