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General NPI Number Information
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NPI Number | 1376550244
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Entity Type | Organization
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Legal Business Name | MARCIA T SAMPSON MD PA
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2140 FM 157 N
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City | MANSFIELD
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State | TX
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Zip | 76031
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Country | US
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Telephone | 817-453-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 2140 FM 157 N
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City | MANSFIELD
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State | TX
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Zip | 76031
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Country | US
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Telephone | 817-453-7700
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARCIA J SAMPSON
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Credential | MD
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Telephone | 817-453-7770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | G8646
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License Number State | TX
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