Provider Demographics
NPI:1427039411
Name:ALIANELL, SAMUEL J (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:J
Last Name:ALIANELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3275 COLLEGE PARK DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4501
Mailing Address - Country:US
Mailing Address - Phone:936-321-0214
Mailing Address - Fax:936-271-0219
Practice Address - Street 1:3275 COLLEGE PARK DR
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-4501
Practice Address - Country:US
Practice Address - Phone:936-321-0214
Practice Address - Fax:936-271-0219
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ4688208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00737299OtherRAILROAD MEDICARE PIN
TX0058MMOtherBCBS
TXF64348Medicare UPIN
TX0058MMOtherBCBS