Healthcare Provider Details

I. General information

NPI: 1326530577
Provider Name (Legal Business Name): SAMA ASTANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2018
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 W COLORADO BLVD STE 525
DALLAS TX
75208-2312
US

IV. Provider business mailing address

5605 N MACARTHUR BLVD
IRVING TX
75038-2617
US

V. Phone/Fax

Practice location:
  • Phone: 214-960-5681
  • Fax: 214-960-5681
Mailing address:
  • Phone: 214-960-5681
  • Fax: 214-960-5681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number44944
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberU9824
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2022016255
License Number StateMO
# 4
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License NumberU9824
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: