Provider Demographics
NPI:1427244474
Name:SUREKA, DIMPLE L (MD)
Entity type:Individual
Prefix:
First Name:DIMPLE
Middle Name:L
Last Name:SUREKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UTSW BILLING
Mailing Address - Street 2:P.O. BOX 845347
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-645-0600
Mailing Address - Fax:214-645-2762
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:MC 8591
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-8591
Practice Address - Country:US
Practice Address - Phone:214-648-1100
Practice Address - Fax:214-648-1666
Is Sole Proprietor?:No
Enumeration Date:2007-09-23
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8353207SG0201X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No208000000XAllopathic & Osteopathic PhysiciansPediatrics