Provider Demographics
NPI:1265933212
Name:SAMMAN ALI SHAH LLC
Entity type:Organization
Organization Name:SAMMAN ALI SHAH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RINCEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WICK
Authorized Official - Suffix:
Authorized Official - Credentials:ADMIN
Authorized Official - Phone:832-905-5940
Mailing Address - Street 1:450 BLOSSOM ST STE D
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4200
Mailing Address - Country:US
Mailing Address - Phone:832-905-5940
Mailing Address - Fax:832-905-5941
Practice Address - Street 1:450 BLOSSOM ST STE D
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4200
Practice Address - Country:US
Practice Address - Phone:832-905-5940
Practice Address - Fax:832-905-5941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty