Provider Demographics
NPI:1396983904
Name:O'CONNOR, SUZANNE GRACE (LCPO)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:GRACE
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:LCPO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1440 REGAL ROW
Mailing Address - Street 2:STE 230
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-3631
Mailing Address - Country:US
Mailing Address - Phone:214-819-8012
Mailing Address - Fax:214-819-8047
Practice Address - Street 1:1440 REGAL ROW
Practice Address - Street 2:STE 230
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-3631
Practice Address - Country:US
Practice Address - Phone:214-819-8012
Practice Address - Fax:214-819-8047
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73224P00000X, 222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist