Provider Demographics
NPI:1508064403
Name:G A SAMMAN MD PA
Entity Type:Organization
Organization Name:G A SAMMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:GHYATH
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-332-4100
Mailing Address - Street 1:PO BOX 58507
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-8507
Mailing Address - Country:US
Mailing Address - Phone:281-332-4100
Mailing Address - Fax:281-332-4166
Practice Address - Street 1:17051 N TEXAS AVE
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4023
Practice Address - Country:US
Practice Address - Phone:281-332-4100
Practice Address - Fax:281-332-4166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX172300901Medicaid
TX172300901Medicaid
TX00178YMedicare PIN