Provider Demographics
NPI:1710133996
Name:SAMUEL ALIANELL MD PA
Entity Type:Organization
Organization Name:SAMUEL ALIANELL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ALIANELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-321-0214
Mailing Address - Street 1:6700 WOODLANDS PKWY
Mailing Address - Street 2:STE 230 BOX 260
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2575
Mailing Address - Country:US
Mailing Address - Phone:936-321-0214
Mailing Address - Fax:936-271-0219
Practice Address - Street 1:111 VISION PARK BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3002
Practice Address - Country:US
Practice Address - Phone:936-321-0214
Practice Address - Fax:936-271-0219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4688208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDP1927OtherRAILROAD MEDICARE GROUP NUMBER
TX00Z520OtherMEDICARE GROUP NUMBER