Provider Demographics
NPI:1467404590
Name:BHARKSUWAN, SAMUEL (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:BHARKSUWAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8668
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77387-8668
Mailing Address - Country:US
Mailing Address - Phone:281-587-1300
Mailing Address - Fax:281-203-5012
Practice Address - Street 1:9303 PINECROFT DR
Practice Address - Street 2:SUITE 380
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3181
Practice Address - Country:US
Practice Address - Phone:281-587-1300
Practice Address - Fax:832-201-8296
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4636207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0430076-02Medicaid
TXK4636OtherTEXAS MEDICAL LICENSE
TXK4636OtherTEXAS MEDICAL LICENSE
TXH03936Medicare UPIN