Samuel T Haddock
Pediatric Emergency Physician
801 7th Ave
Fort Worth
, Texas 76104-2733
Samuel T Haddock
Pediatric Emergency Physician
801 7th Ave
Fort Worth
, Texas 76104-2733
(682) 885-7347
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About
Features
Specialties
- Pediatric Emergency Physician
Languages spoken
- English
Location
First Address
- Samuel T Haddock
- Po Box 99213
- Fort Worth, TX
- Zip : 76199-0213
- Fax : (682) 885-7347
- Phone : (682) 885-1855
Second Address
- Samuel T Haddock
- 801 7th Ave
- Fort Worth, TX
- Zip : 76104-2733
- Fax : (682) 885-7499
- Phone : (682) 885-4095
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207PP0204X | Pediatric Emergency Physician | L0812 | TX |
National Provider Identifier
| NPI | 1629171434 |
|---|---|
| Provider Name | Samuel T Haddock |
| First Address | Fort Worth, TX 76199-0213 |
| Second Address | Fort Worth, TX 76104-2733 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/09/2006 |
| Last Update Date | 12/05/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 006041002 | (05) | TX |
| 006041003 | (05) | TX |
| 00L42V | BCBSTX GRP PIN (01) | TX |
| 10032051 | AMERIGROUP PIN (01) | TX |
| 124211 | SUPERIOR PIN (01) | TX |
| 137283103 | (05) | TX |
| 137345805 | (05) | TX |
| 138456101 | FIRSTCARE PIN (01) | TX |
| 1669442042 | GRP NPI NUMBER (01) | |
| 1746111 | FIRSTHEALTH PIN (01) | TX |
| 1866576 | UHC PIN (01) | TX |
| 2840117 | CIGNA PIN (01) | TX |
| 5297726 | AETNA PIN (01) | TX |
| 8H8785 | BCBSTX IND PIN (01) | TX |
| G74848 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.