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General NPI Number Information
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NPI Number | 1427238575
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Entity Type | Individual
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Provider Name | HEMANTH KUMAR SAMUEL D.D.S
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Gender | Male
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 11/03/2015
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Provider Practice Location Address
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Address Line | 410 E FAIRMONT PKWY SUITE E
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City | LA PORTE
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State | TX
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Zip | 77571-6498
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Country | US
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Telephone | 281-470-2749
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Fax | 281-470-0905
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Provider Business Mailing Address
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Address Line | 410 E FAIRMONT PKWY SUITE E
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City | LA PORTE
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State | TX
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Zip | 77571-6498
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Country | US
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Telephone | 281-470-2749
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Fax | 281-470-0905
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 56030
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 25362
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License Number State | TX
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