Provider Demographics
NPI:1003497009
Name:SOH OF TEXAS, SAMSON LIU PLLC
Entity Type:Organization
Organization Name:SOH OF TEXAS, SAMSON LIU PLLC
Other - Org Name:THE DENTISTS OF BARTON CREEK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNSHINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-362-4986
Mailing Address - Street 1:2700 BARTON CREEK BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-1637
Mailing Address - Country:US
Mailing Address - Phone:737-203-9006
Mailing Address - Fax:737-203-9007
Practice Address - Street 1:2700 BARTON CREEK BLVD STE 110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-1637
Practice Address - Country:US
Practice Address - Phone:737-203-9006
Practice Address - Fax:737-203-9007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-20
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty