Provider Demographics
NPI:1851796775
Name:GRAEF, SAMANTHA A (PA-C)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:A
Last Name:GRAEF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:DORER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1512 TOWN CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-7679
Mailing Address - Country:US
Mailing Address - Phone:512-324-4875
Mailing Address - Fax:512-324-4876
Practice Address - Street 1:1512 TOWN CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-7679
Practice Address - Country:US
Practice Address - Phone:512-324-4875
Practice Address - Fax:512-324-4876
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00000363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical