Iannaccone, Susan Theresa

Iannaccone, Susan Theresa is an individual health care provider with primary practice located at 5323 Harry Hines Boulevard , Dallas TX 75390-7208. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Iannaccone, Susan Theresa can be contacted via phone (214) 456-2768.

Contact Information

Primary practice address
5323 Harry Hines Boulevard Dallas TX 75390-7208
Phone: (214) 456-2768
Fax: (214) 456-6898
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X H8691 Texas
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X H8691 Texas

Profile Details

NPI number 1023078607
LBN Legal business name Iannaccone, Susan Theresa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2006
Last updated Apr 26th, 2024 - about 5 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023078607 NPPES
Texas MEDICAID 105947903

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