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BRADLEY E. SAMUELSON MD PA NPI 1003002262

NPI Profile

NPI: 1003002262
Provider Name: BRADLEY E. SAMUELSON, MD PA
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
1004 BROOK AVE
WICHITA FALLS, TX
ZIP 76301
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Phone: (940) 687-7100

BRADLEY E. SAMUELSON, MD PA is a healthcare provider in Wichita Falls, TX.The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. BRADLEY E. SAMUELSON, MD PA NPI is 1003002262. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1004 BROOK AVE
WICHITA FALLS, TX
ZIP 76301-007
Phone: (940) 687-7100
Fax: (940) 687-7104

The provider's authorized official is Lili Samuelson .
The authorized official title is Manager and has the following contact phone number (940) 687-7100.

The enumeration date for this NPI number is 9/21/2007 and was last updated on 2/19/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RC0000XInternal MedicineCardiovascular DiseaseYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100555YMEDICARE PINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 10/13/2019

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