Individual
MCKENZIE LOUIS SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
12222 MERIT DR STE 600, DALLAS, TX 75251-3294
(972) 715-5000
(972) 715-9976
Mailing address
1135 RIVERVIEW RNCH, BRAZORIA, TX 77422-7937
(616) 240-7552
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1210439
TX
367500000X
Certified Registered Nurse Anesthetist
15894
WI
367500000X
Certified Registered Nurse Anesthetist
RN2341474
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932831716
—
WI
Enumeration date
06/29/2022
Last updated
12/17/2025
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