Provider Demographics
NPI:1346891694
Name:SAMUELS PEDIATRICS TEXAS, PLLC
Entity Type:Organization
Organization Name:SAMUELS PEDIATRICS TEXAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTEL
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:SAMUELS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-673-3111
Mailing Address - Street 1:9065 WATERCREST CIR E
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-2850
Mailing Address - Country:US
Mailing Address - Phone:361-673-3111
Mailing Address - Fax:
Practice Address - Street 1:427 E DURANTA AVE STE 102
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:TX
Practice Address - Zip Code:78516-3409
Practice Address - Country:US
Practice Address - Phone:956-781-4792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty