MEDICARE: DAVID ALEXANDER SAMUELS M.D.

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
1	207RC0000X	Cardiovascular Disease Physician	G168646	CA
2	207RC0000X	Cardiovascular Disease Physician	DR.0053203	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	060021728	OTHER	TX	RR MEDICARE
3	060051578	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	84G068	OTHER	TX	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	83610K	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1487653622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ALEXANDER SAMUELS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1629
Second Line	:
City	:	RANCHO SANTA FE
State	:	CA
Zip	:	92067-1629
Country	:	US
Telephone Number	:	713-851-0028
Fax Number	:

Provider Business Practice Location Address
First Line	:	16639 LAS CUESTAS
Second Line	:
City	:	RANCHO SANTA FE
State	:	CA
Zip	:	92067
Country	:	US
Telephone Number	:	713-851-0028
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	12/12/2025

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Directions to “ DAVID ALEXANDER SAMUELS M.D.” Practice Location

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