MEDICARE: DR. SAMIR SUKKAR 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	2086S0122X	Plastic and Reconstructive Surgery Physician	J7218	TX

General Provider Information

NPI Number	:	1902844509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMIR SUKKAR M.D.

Provider Business Mailing Address
First Line	:	14018 AESTHETIC CIR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77062-2373
Country	:	US
Telephone Number	:	281-990-8487
Fax Number	:	713-281-2685

Provider Business Practice Location Address
First Line	:	14018 AESTHETIC CIR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77062-2373
Country	:	US
Telephone Number	:	281-990-8487
Fax Number	:	713-481-2685

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

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	09/23/2021

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