Individual
SAMUEL M LANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 SEVENTH AVE, STE 120, FORT WORTH, TX 76104
(682) 885-2500
(682) 885-2510
Mailing address
801 SEVENTH AVE, REVENUE MANAGEMENT, FORT WORTH, TX 76104
(682) 885-4157
(682) 885-1903
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
G8232
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U87Z
BCBSTX GRP PIN
TX
01
—
0772105
CIGNA PIN
TX
01
—
10028600
AMERIGROUP PIN
TX
01
—
124225
SUPERIOR PIN
TX
01
—
1392896
UHC PIN
TX
01
—
1640392
FIRSTHEALTH PIN
TX
01
—
1750369203
GRP NPI NUMBER
—
01
—
413473
PHCS PIN
TX
01
—
4292606
AETNA PIN
TX
01
—
87V782
BCBSTX IND PIN
TX
Enumeration date
10/02/2006
Last updated
07/09/2007
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