Individual
SAMUEL B PEGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3316 WILLIAMS DR STE 150, GEORGETOWN, TX 78628-2891
(512) 244-4272
(512) 244-2895
Mailing address
2000 S MAYS ST STE 201, ROUND ROCK, TX 78664-7580
(512) 244-4272
(512) 244-2895
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
F9937
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128203006
—
TX
Enumeration date
12/07/2005
Last updated
08/24/2021
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