=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821397621
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAMUEL L. ATTIA, M.D., P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/18/2011
-----------------------------------------------------
Last Update Date | 03/18/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6624 FANNIN ST SUITE 1460
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77030-2312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-790-0557
-----------------------------------------------------
Fax | 713-790-0592
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6624 FANNIN ST SUITE 1460
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77030-2312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-790-0557
-----------------------------------------------------
Fax | 713-790-0592
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. SAMUEL LABIB ATTIA
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 713-790-0557
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208800000X
-----------------------------------------------------
Taxonomy Name | Urology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------