Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | K1295 | TX |
N | 208000000X | Pediatrician | K1295 | TX |
Y | 2080P0210X | Pediatric Nephrologist | K1295 | TX |
NPI | 1427076744 |
---|---|
Provider Name | Joshua A Samuels |
First Address | Houston, TX 77216-1088 |
Second Address | Houston, TX 77030-3000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 12/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8F6692 | BCBS (01) | TX |
H83533 | (02) | TX |