Candida Dawn Suffridge, MD, PHD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

Q1029 Issued in TX

Practice address

1507 Rivery Blvd
Georgetown, TX 78628

Phone

(512) 509-9550

Fax

(512) 509-9555

NPI assigned

Jul 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1407054646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 RIVERY BLVD",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "78628",
            "telephone_number": "512-509-9550",
            "fax_number": "512-509-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUFFRIDGE",
        "first_name": "CANDIDA",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "2515",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q1029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boyce Stuart, D C
• Paul Edward Stubbs, DDS
• David B Stuetelberg, D.C.
• Bonnie S Stump, MD
• Mark Daniel Sturm, O.D.
• Netra L Sukhatankar, O.T.
• Carsen Noel Sulzer, MD
• Summit Wellness - Central Texas LLC
• Sunshine Counselor, LLC
• Brenna Sura, DDS

• Family Medicine Physician in Georgetown, TX
• Providers in Georgetown, 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 May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.