Provider Demographics
NPI:1326673153
Name:BAPTISTE, SAMUEL JEFFREY
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:JEFFREY
Last Name:BAPTISTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 E LANCE LEAF RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77381-2826
Mailing Address - Country:US
Mailing Address - Phone:340-332-9375
Mailing Address - Fax:
Practice Address - Street 1:32 E LANCE LEAF RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77381-2826
Practice Address - Country:US
Practice Address - Phone:340-332-9375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor