Individual
HEATHER SAMPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-0591
(409) 772-1221
(409) 772-1224
Mailing address
2895 TUSCANIA LN, LEAGUE CITY, TX 77573-2385
(806) 518-8296
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
N7581
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N7581
TEXAS LICENSE NUMBER
TX
Enumeration date
04/17/2008
Last updated
03/07/2023
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