Individual
MR. ITALO AUGUSTO SAMANO
Active
Individual
MR. ITALO AUGUSTO SAMANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
23724
TX
103TC0700X
Clinical Psychologist
Primary
23724
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-0624198
TAX ID # FOR GROUP
TX
05
—
128813606
—
TX
01
—
151188301
MEDICAID GROUP
TX
Enumeration date
05/31/2006
Last updated
07/02/2026
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