Provider Demographics
NPI:1043771272
Name:SAMER NACHAWATI PLLC
Entity Type:Organization
Organization Name:SAMER NACHAWATI PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER / PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SAMER
Authorized Official - Middle Name:M
Authorized Official - Last Name:NACHAWATI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-698-2371
Mailing Address - Street 1:929 N GALLOWAY AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-7413
Mailing Address - Country:US
Mailing Address - Phone:214-535-7892
Mailing Address - Fax:
Practice Address - Street 1:929 N GALLOWAY AVE STE 220
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-7413
Practice Address - Country:US
Practice Address - Phone:214-535-7892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty