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Individual
SAMUEL WATKINS
Active
Individual
SAMUEL WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01029
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8N9113
BLUE SHIELD
TX
Enumeration date
04/08/2006
Last updated
01/25/2022
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