Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | P9445 | TX |
NPI | 1073806709 |
---|---|
Provider Name | Dr. Samara Lynn Potter |
First Address | Houston, TX 77030-2303 |
Second Address | Houston, TX 77030-2608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2011 |
Last Update Date | 06/07/2017 |