Provider Demographics
NPI:1568729457
Name:HOUSTON, SAMANTHA LAURENT (MD)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:LAURENT
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:SAMANTHA
Other - Middle Name:LAURENT
Other - Last Name:FUQUA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2301 S LAMAR BLVD
Mailing Address - Street 2:ATTN: HOSPITALIST OFFICE
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5373
Mailing Address - Country:US
Mailing Address - Phone:662-232-8100
Mailing Address - Fax:
Practice Address - Street 1:2301 S LAMAR BLVD
Practice Address - Street 2:ATTN: HOSPITALIST OFFICE
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5373
Practice Address - Country:US
Practice Address - Phone:662-232-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-16
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS24374208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist