Healthcare Provider Details

I. General information

NPI: 1124415195
Provider Name (Legal Business Name): RICHARD SAMADE PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MR. RICHARD ABDUL-SAMAD

II. Dates (important events)

Enumeration Date: 04/17/2015
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

376 W 10TH AVE OHIO STATE UNIVERSITY MEDICAL CENTER
COLUMBUS OH
43210-1280
US

IV. Provider business mailing address

5323 HARRY HINES BLVD
DALLAS TX
75390-7201
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-6194
  • Fax:
Mailing address:
  • Phone: 214-648-3916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberT6707
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberT6707
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: