Individual
SAMUEL T HADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 7TH AVE, FORT WORTH, TX 76104-2733
(682) 885-4095
(682) 885-7499
Mailing address
PO BOX 99213, FORT WORTH, TX 76199-0213
(682) 885-1855
(682) 885-7347
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
L0812
TX
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
L0812
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006041002
—
TX
05
—
006041003
—
TX
01
—
00L42V
BCBSTX GRP PIN
TX
01
—
10032051
AMERIGROUP PIN
TX
01
—
124211
SUPERIOR PIN
TX
05
—
137283103
—
TX
05
—
137345805
—
TX
01
—
138456101
FIRSTCARE PIN
TX
01
—
1669442042
GRP NPI NUMBER
—
01
—
1746111
FIRSTHEALTH PIN
TX
01
—
1866576
UHC PIN
TX
01
—
2840117
CIGNA PIN
TX
01
—
5297726
AETNA PIN
TX
01
—
8H8785
BCBSTX IND PIN
TX
Enumeration date
09/07/2006
Last updated
04/16/2026
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