# SAMMY LERMA III MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760542542
- **Authorized official:** SAMMY LERMA III MD (OWNER)
- **Authorized official phone:** (512) 321-3311

## Contact information

- **Practice address:** 1109 CHURCH ST, BASTROP, TX 78602-3206
- **Practice address phone:** (512) 321-3311
- **Practice address fax:** (512) 321-2611
- **Mailing address:** PO BOX 664, BASTROP, TX 78602-0664
- **Mailing address phone:** (512) 321-3311
- **Mailing address fax:** (512) 321-2611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | H6375 | TX | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363LF0000X | Family Nurse Practitioner | 617058 | TX | — |
| 363LF0000X | Family Nurse Practitioner | 791283 | TX | — |

## Other

- **Enumeration date:** 12/11/2006
- **Last updated:** 09/08/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 080698601 | — | TX |
| 05 | — | 080698602 | — | TX |
| 05 | — | 080698603 | — | TX |
| 01 | — | DB6623 | RAILROAD MEDICARE | TX |