Provider Demographics
NPI:1467678029
Name:DAVID E. SAMARA, M.D., P.A.
Entity Type:Organization
Organization Name:DAVID E. SAMARA, M.D., P.A.
Other - Org Name:PEDIATRIC PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-519-0545
Mailing Address - Street 1:PO BOX 260877
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75026-0877
Mailing Address - Country:US
Mailing Address - Phone:972-519-0545
Mailing Address - Fax:972-612-7117
Practice Address - Street 1:3801 W 15TH ST
Practice Address - Street 2:SUITE #D-120
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-4737
Practice Address - Country:US
Practice Address - Phone:972-519-0545
Practice Address - Fax:972-964-0563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty