SAMUEL T HADDOCK MD NPI 1629171434

NPI Information

NPI: 1629171434
Provider Name: SAMUEL T HADDOCK, MD
Classification: Emergency Medicine - 207PP0204X
Entity Type: Individual

Specialization: Pediatric Emergency Medicine

PECOS Registration: Yes

Address:
801 7TH AVE
FORT WORTH, TX
ZIP 76104
Phone: (682) 885-4095
Get Directions

Samuel T Haddock, MD is a pediatric emergency medicine emergency medicine in Fort Worth, TX. The provider is pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department. Samuel T Haddock, MD NPI is 1629171434. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

801 7TH AVE
FORT WORTH, TX
ZIP 76104-733
Phone: (682) 885-4095
Fax: (682) 885-7499

The NPI 1629171434 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/7/2006 and was last updated on 5/12/2011.

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
1	207PP0204X	Emergency Medicine	Pediatric Emergency Medicine	L0812	TEXAS	Yes

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
1	1746111	OTHER	TEXAS	FIRSTHEALTH PIN
2	137283103	MEDICAID	TEXAS
3	TXB121417	MEDICARE PIN	TEXAS
4	8H8785	OTHER	TEXAS	BCBSTX IND PIN
5	2840117	OTHER	TEXAS	CIGNA PIN
6	138456101	OTHER	TEXAS	FIRSTCARE PIN
7	006041002	MEDICAID	TEXAS
8	5297726	OTHER	TEXAS	AETNA PIN
9	137345805	MEDICAID	TEXAS
10	8B9945	MEDICARE PIN	TEXAS
11	00L42V	OTHER	TEXAS	BCBSTX GRP PIN
12	1669442042	OTHER		GRP NPI NUMBER
13	124211	OTHER	TEXAS	SUPERIOR PIN
14	1866576	OTHER	TEXAS	UHC PIN
15	10032051	OTHER	TEXAS	AMERIGROUP PIN
16	00L42V	MEDICARE PIN	TEXAS
17	G74848	MEDICARE UPIN
18	006041003	MEDICAID	TEXAS

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: 4/28/2024

NPI Synchronization or Removal

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