Provider Demographics
NPI:1477861730
Name:SAMSEL, RYANN MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:RYANN
Middle Name:MARIE
Last Name:SAMSEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 N INTERSTATE 35 STE 200
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-5144
Mailing Address - Country:US
Mailing Address - Phone:940-323-3400
Mailing Address - Fax:940-323-3410
Practice Address - Street 1:2900 N INTERSTATE 35 STE 200
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-5144
Practice Address - Country:US
Practice Address - Phone:940-323-3400
Practice Address - Fax:940-323-3410
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07018363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical