Provider Demographics
NPI:1316966294
Name:STOKS, SUZETTE M (PHD)
Entity type:Individual
Prefix:DR
First Name:SUZETTE
Middle Name:M
Last Name:STOKS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-0099
Mailing Address - Country:US
Mailing Address - Phone:210-654-1900
Mailing Address - Fax:
Practice Address - Street 1:14800 SAN PEDRO AVE STE 214
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-3734
Practice Address - Country:US
Practice Address - Phone:210-381-3573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31775103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00125021OtherRAILROAD
TX0049KMOtherBCBS
TX151391302Medicaid
TX609954Medicare ID - Type Unspecified
TXP52887Medicare UPIN