Individual
DR. TODD E. SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1250 8TH AVE, SUITE 205, FORT WORTH, TX 76104-4158
(817) 335-8151
(817) 926-2531
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 926-2531
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
H2007
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130524508
—
TX
01
—
P01034921
RAILROAD MEDICARE
TX
Enumeration date
09/20/2006
Last updated
06/21/2012
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