Individual
SAMUEL FITZGERALD BRODERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5323 HARRY HINES BLVD # E4.300, DALLAS, TX 75390-7208
(214) 648-3022
Mailing address
6451 BRENTWOOD STAIR RD STE 200, FORT WORTH, TX 76112-3200
(817) 496-9700
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1245737188
TX
207P00000X
Emergency Medicine Physician
A179942
CA
207P00000X
Emergency Medicine Physician
Primary
T0728
TX
390200000X
Student in an Organized Health Care Education/Training Program
T68740844
VA
Other
Enumeration date
04/08/2018
Last updated
02/14/2023
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