SUSAN THERESA IANNACCONE MD NPI 1023078607

NPI Information

NPI: 1023078607
Provider Name: SUSAN THERESA IANNACCONE, MD
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

PECOS Registration: Yes

Address:
5323 HARRY HINES BOULEVARD
DALLAS, TX
ZIP 75390
Phone: (214) 456-2768
Get Directions

Susan Theresa Iannaccone, MD is a neurology psychiatry neurology in Dallas, TX. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. Susan Theresa Iannaccone, MD NPI is 1023078607. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5323 HARRY HINES BOULEVARD
DALLAS, TX
ZIP 75390-208
Phone: (214) 456-2768
Fax: (214) 456-6898

The NPI 1023078607 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/27/2006 and was last updated on 4/26/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084N0400X	Psychiatry & Neurology	Neurology	H8691	TEXAS	Yes
2	2084N0402X	Psychiatry & Neurology	Neurology with Special Qualifications in Child Neurology	H8691	TEXAS	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	105947903	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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