Provider Demographics
NPI:1134107782
Name:HARTMAN, SAMUEL CHRISTIAN (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:CHRISTIAN
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:13725 NORTHWEST BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-5127
Mailing Address - Country:US
Mailing Address - Phone:361-387-3616
Mailing Address - Fax:361-387-3504
Practice Address - Street 1:13725 NORTHWEST BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-5127
Practice Address - Country:US
Practice Address - Phone:361-387-3616
Practice Address - Fax:361-387-3504
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK0487207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G33207Medicare UPIN