Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0129X | Vascular Surgeon | C128526 | CA |
Y | 2086S0129X | Vascular Surgeon | L3462 | TX |
NPI | 1093799165 |
---|---|
Provider Name | James Buchanan Sampson |
First Address | San Antonio, TX 78234-4504 |
Second Address | San Antonio, TX 78234-4504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2005 |
Last Update Date | 12/10/2019 |