Healthcare Provider Details

I. General information

NPI: 1083431340
Provider Name (Legal Business Name): SAMEER SYED MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2024
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 E RALPH HALL PKWY STE 110
ROCKWALL TX
75032-6879
US

IV. Provider business mailing address

7668 ELDORADO PKWY STE 300
MCKINNEY TX
75070-5753
US

V. Phone/Fax

Practice location:
  • Phone: 214-817-4425
  • Fax: 972-674-2788
Mailing address:
  • Phone: 214-817-4425
  • Fax: 972-674-2788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: AMANDA NICOLE MELELEU
Title or Position: PROVIDER ENROLLMENT
Credential:
Phone: 214-817-4225