Provider Demographics
NPI:1447454111
Name:MCCALL, SUZIE SOLENBERGER (MS,RD,LD)
Entity type:Individual
Prefix:MS
First Name:SUZIE
Middle Name:SOLENBERGER
Last Name:MCCALL
Suffix:
Gender:F
Credentials:MS,RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 S MAIN ST STE 205
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-5390
Mailing Address - Country:US
Mailing Address - Phone:817-513-0656
Mailing Address - Fax:817-764-7400
Practice Address - Street 1:603 S MAIN ST STE 205
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-5390
Practice Address - Country:US
Practice Address - Phone:817-513-0656
Practice Address - Fax:817-764-7400
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06161133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered