Provider Demographics
NPI:1558133264
Name:SAMURAH, ZAINAB (AGACNP)
Entity Type:Individual
Prefix:
First Name:ZAINAB
Middle Name:
Last Name:SAMURAH
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7526 KEYSTONE BLOSSOM TRL
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3070
Mailing Address - Country:US
Mailing Address - Phone:832-921-3288
Mailing Address - Fax:
Practice Address - Street 1:705 S FRY RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2251
Practice Address - Country:US
Practice Address - Phone:832-921-3288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1113537363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner