Provider Demographics
NPI:1346206554
Name:SOLOMON SAM BRICKMAN MD PA
Entity Type:Organization
Organization Name:SOLOMON SAM BRICKMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SOLOMON
Authorized Official - Middle Name:SAM
Authorized Official - Last Name:BRICKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-465-4865
Mailing Address - Street 1:11730 FM 1960 RD W
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3514
Mailing Address - Country:US
Mailing Address - Phone:281-955-2263
Mailing Address - Fax:281-955-7990
Practice Address - Street 1:11730 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3514
Practice Address - Country:US
Practice Address - Phone:281-955-2263
Practice Address - Fax:281-955-7990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0091MHOtherBCBS
TX0091MHOtherBCBS
TX00560YMedicare PIN