Provider Demographics
NPI:1669010179
Name:SAMANTHA SYMONS MD PLLC
Entity Type:Organization
Organization Name:SAMANTHA SYMONS MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SYMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-585-1217
Mailing Address - Street 1:510 HEARN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-4516
Mailing Address - Country:US
Mailing Address - Phone:512-521-0868
Mailing Address - Fax:
Practice Address - Street 1:510 HEARN ST STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-4516
Practice Address - Country:US
Practice Address - Phone:512-521-0868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-16
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health