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NPI Code Detail

MEDICARE: SAMUEL ORNELAS MD

MEDICARE: SAMUEL ORNELAS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician9408359KS
22085R0202XDiagnostic Radiology PhysicianR6862TX
32085R0202XDiagnostic Radiology Physician0438267KS

General Provider Information

NPI Number : 1467866178
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL ORNELAS MD
Provider Business Mailing Address
First Line : 1010 N KANSAS ST
Second Line :
City : WICHITA
State : KS
Zip : 67214-3124
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1010 N KANSAS ST
Second Line :
City : WICHITA
State : KS
Zip : 67214-3124
Country : US
Telephone Number : 316-293-2665
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2014
Last Update Date : 05/28/2026

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