MEDICARE: DR. SAMUEL ADAM GEURKINK DO

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	207RH0003X	Hematology & Oncology Physician	U2497	TX
2	207R00000X	Internal Medicine Physician	BP10059676	TX

General Provider Information

NPI Number	:	1932638467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMUEL ADAM GEURKINK DO

Provider Business Mailing Address
First Line	:	PO BOX 911230
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75391-1230
Country	:	US
Telephone Number	:	972-997-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	9750 HILLWOOD PKWY
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76177-1507
Country	:	US
Telephone Number	:	817-697-5620
Fax Number	:	817-379-2024

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

Provider Enumeration Date	:	06/08/2017
Last Update Date	:	08/03/2023

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