Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | P9949 | TX |
Y | 207RI0011X | Interventional Cardiology | P9949 | TX |
NPI | 1033360748 |
---|---|
Provider Name | Dr. Paulraj Samuel |
First Address | Humble, TX 77338-4386 |
Second Address | Humble, TX 77338-4386 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2008 |
Last Update Date | 07/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
363974201 | (05) | TX |