Provider Demographics
NPI:1265800940
Name:CLINIC AT SAMSONS
Entity type:Organization
Organization Name:CLINIC AT SAMSONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:ADA-IHUOMA
Authorized Official - Last Name:NDUKWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-850-7162
Mailing Address - Street 1:17514 ENDEL WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2762
Mailing Address - Country:US
Mailing Address - Phone:713-459-9892
Mailing Address - Fax:281-946-8466
Practice Address - Street 1:3129 KINGSLEY DRIVE
Practice Address - Street 2:UNIT 610
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584
Practice Address - Country:US
Practice Address - Phone:832-850-7162
Practice Address - Fax:281-946-8466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-11
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center