Provider Demographics
NPI:1790744399
Name:SAMAL, ADITYA K (MD)
Entity Type:Individual
Prefix:DR
First Name:ADITYA
Middle Name:K
Last Name:SAMAL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:13325 HARGRAVE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4539
Mailing Address - Country:US
Mailing Address - Phone:281-469-8007
Mailing Address - Fax:281-469-8042
Practice Address - Street 1:13325 HARGRAVE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4539
Practice Address - Country:US
Practice Address - Phone:281-469-8007
Practice Address - Fax:281-469-8042
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2017-02-23
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Provider Licenses
StateLicense IDTaxonomies
TXL5122207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156925302Medicaid
TX156925302Medicaid
TX8C0288Medicare PIN