Individual
SAM W BUCHANAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
800 W MAGNOLIA AVE, FORT WORTH, TX 76104-4611
(817) 759-7000
(817) 333-0173
Mailing address
PO BOX 100937, FORT WORTH, TX 76185-0937
(817) 313-4616
(817) 333-0173
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
E4229
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1042053-03
—
TX
Enumeration date
06/15/2006
Last updated
09/13/2012
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