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General NPI Number Information
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NPI Number | 1275730707
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Entity Type | Organization
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Legal Business Name | SAM T GEORGE, PA
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1211 E 6TH ST STE 300
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City | BONHAM
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State | TX
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Zip | 75418-4095
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Country | US
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Telephone | 903-640-1422
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Fax | 903-640-4275
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Provider Business Mailing Address
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Address Line | 1211 E 6TH ST STE 300
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City | BONHAM
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State | TX
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Zip | 75418-4095
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Country | US
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Telephone | 903-640-1422
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Fax | 903-640-4275
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Authorized Official
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Title or Position | CHAIRMAN
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Name | DR. SAM G THOYAKULATHU
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Credential | M.D.
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Telephone | 903-640-1422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | J5496
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License Number State | TX
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