Basic Information
| Provider Information | |||||||||
| NPI: | 1427244474 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SUREKA | ||||||||
| FirstName: | DIMPLE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | UTSW BILLING | ||||||||
| Address2: | P.O. BOX 845347 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752845347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146450600 | ||||||||
| FaxNumber: | 2146452762 | ||||||||
| Practice Location | |||||||||
| Address1: | 5323 HARRY HINES BLVD | ||||||||
| Address2: | MC 8591 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753908591 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146481100 | ||||||||
| FaxNumber: | 2146481666 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2007 | ||||||||
| LastUpdateDate: | 01/12/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207SG0201X | N8353 | TX | Y | Allopathic & Osteopathic Physicians | Medical Genetics | Clinical Genetics (M.D.) | 208000000X | N8353 | TX | N | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.