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General NPI Number Information
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NPI Number | 1699200469
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Entity Type | Individual
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Provider Name | SAMAH HUSSAIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/28/2017
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 1007 39TH AVE SE
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City | PUYALLUP
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State | WA
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Zip | 98374-2192
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Country | US
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Telephone | 253-435-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 11511 SHADOW CREEK PKWY
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City | PEARLAND
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State | TX
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Zip | 77584-7298
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Country | US
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Telephone | 713-442-0000
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | U1037
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ML60754607
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License Number State | WA
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