Individual
SAMUAL ROBERT TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6550 FANNIN ST, SUITE 1601, HOUSTON, TX 77030-2717
(713) 441-5155
Mailing address
6550 FANNIN ST, SUITE 1661A, HOUSTON, TX 77030-2717
(713) 441-5155
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
L1482
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157521902
—
TX
01
—
157521903
CSHCN (MEDICAID)
TX
01
—
8V8605
BLUE CROSS BLUE SHIELD
TX
01
—
P00351944
MEDICARE RAILROAD
TX
Enumeration date
07/07/2006
Last updated
01/28/2011
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