Provider Demographics
NPI:1831174077
Name:SAMEE, OMAR A
Entity type:Individual
Prefix:MR
First Name:OMAR
Middle Name:A
Last Name:SAMEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 PRESTON AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-2019
Mailing Address - Country:US
Mailing Address - Phone:281-249-2251
Mailing Address - Fax:281-249-2282
Practice Address - Street 1:4001 PRESTON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-2019
Practice Address - Country:US
Practice Address - Phone:281-249-2251
Practice Address - Fax:281-249-2282
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04225363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX190369201Medicaid
TX8J4150Medicare PIN