Provider Demographics
NPI:1376970590
Name:LORENZO K. SAMPSON, M.D., P.A.
Entity Type:Organization
Organization Name:LORENZO K. SAMPSON, M.D., P.A.
Other - Org Name:SURGICAL SERVICES OF LORENZO K SAMPSON, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORENZO
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:SAMMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-592-6300
Mailing Address - Street 1:PO BOX 5617
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77325-5617
Mailing Address - Country:US
Mailing Address - Phone:281-592-6300
Mailing Address - Fax:281-592-6305
Practice Address - Street 1:22999 HIGHWAY 59 N
Practice Address - Street 2:SUITE 290 B
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-4412
Practice Address - Country:US
Practice Address - Phone:281-592-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8468208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty