Provider Demographics
NPI:1760232722
Name:UNANG, SAMUEL (AGNP)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:
Last Name:UNANG
Suffix:
Gender:M
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 TWIN KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-3710
Mailing Address - Country:US
Mailing Address - Phone:240-334-8494
Mailing Address - Fax:
Practice Address - Street 1:421 TWIN KNOLL DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-3710
Practice Address - Country:US
Practice Address - Phone:240-334-8494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAG01240007363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty