Ross, Theodora Suzanne

Ross, Theodora Suzanne is an individual health care provider with primary practice located at 5323 Harry Hines Blvd. , Dallas TX 75390-7208. She recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hematology, Allopathic & Osteopathic Physicians / Medical Oncology, Allopathic & Osteopathic Physicians / Hematology & Oncology. Allopathic & Osteopathic Physicians / Hematology & Oncology is her primary health care specialty. Ross, Theodora Suzanne can be contacted via phone (214) 645-4673.

Contact Information

Primary practice address
5323 Harry Hines Blvd. Dallas TX 75390-7208
Phone: (214) 645-4673
Fax: (214) 645-2610
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301075061 Michigan
Allopathic & Osteopathic Physicians / Hematology 207RH0000X 4301075061 Michigan
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X 4301075061 Michigan
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X P2161 Texas
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X P2161 Texas

Profile Details

NPI number 1700959715
LBN Legal business name Ross, Theodora Suzanne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2006
Last updated Oct 15th, 2014 - about 12 years 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 1700959715 NPPES
Michigan MEDICAID 4129067
Michigan Other TXB147854
Michigan MEDICAID 295867001

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