Suzanne E Mack, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

J3540 Issued in TX

Practice address

1401 N Elm St
Denton, TX 76201-3089

Phone

(940) 591-8447

Fax

(940) 484-5299

NPI assigned

Jan 19, 2007

Last updated

Aug 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Suzanne E Mack, M.D., P.a.

  dba North Texas Institute for Functional Medicine

  • Clinic/Center
  • Denton, TX
  • NPI 1619020203
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1174676761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 N ELM ST",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762013089",
            "telephone_number": "940-591-8447",
            "fax_number": "940-484-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N ELM ST",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762013089",
            "telephone_number": "940-591-8447",
            "fax_number": "940-484-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "SUZANNE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J3540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• M&D Specialty Services PA
• M&H Management, Inc. (TRIO Home Care)
• Raymond Jason Mac
• Andrea Mack, BCBA, LBA
• Kaitlyn Marie Mack, LVN
• Rachael Macomber, LCSW
• Angie Lynn Madden, LMSW
• Tracy Denise Maddoux, LCSW
• McKayla Madison, MS, RD, LD
• Lalit Kumar Mahajan, MD

• Family Medicine Physician in Denton, TX
• Providers in Denton, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.