Provider Demographics
NPI:1609065952
Name:SAMIR K NATH MD PA
Entity Type:Organization
Organization Name:SAMIR K NATH MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:NATH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-422-7970
Mailing Address - Street 1:2802 GARTH RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3900
Mailing Address - Country:US
Mailing Address - Phone:281-422-7970
Mailing Address - Fax:281-422-7960
Practice Address - Street 1:2802 GARTH RD
Practice Address - Street 2:SUITE 115
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3900
Practice Address - Country:US
Practice Address - Phone:281-422-7970
Practice Address - Fax:281-422-7960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH65369Medicare UPIN