Individual
ELIZABETH SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4325 N JOSEY LN STE 211, CARROLLTON, TX 75010-4637
(214) 483-5665
(214) 483-5684
Mailing address
4325 N JOSEY LN STE 211, CARROLLTON, TX 75010-4637
(214) 483-5665
(214) 483-5684
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
M0252
TX
2084N0600X
Clinical Neurophysiology Physician
M0252
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172460101
—
TX
05
—
172460102
—
TX
05
—
172460103
—
TX
01
—
8G4625
BCBS
TX
01
—
P00207238
RR MEDICARE
TX
Enumeration date
06/30/2006
Last updated
07/20/2009
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