Individual
DIANA TRESSA SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11615 ANGUS RD, SUITE 225, AUSTIN, TX 78759-4078
(512) 372-4554
Mailing address
5717 TRIBUNE WAY, PLANO, TX 75094-4505
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
N4061
TX
2084P0804X
Child & Adolescent Psychiatry Physician
N4061
TX
Other
Enumeration date
04/24/2007
Last updated
03/21/2012
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