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Individual

MRS. SAMARA S LOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RKT

Contact information

Practice address
1201 E 9TH ST, BONHAM, TX 75418-4059
(903) 583-6542
Mailing address
1201 EAST 9TH STREET, SAM RAYBURN MEMORIAL VETERANS CENTER, BONHAM, TX 75418-4059
(903) 583-6542

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1981
IL

Other

Enumeration date
09/07/2016
Last updated
09/07/2016
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