MEDICARE: DR. SAM SAWAYA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	136829	DC
2	207R00000X	Internal Medicine Physician	N2780	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	P00787831	OTHER	TX	RRMCR

General Provider Information

NPI Number	:	1023264298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAM SAWAYA M.D.

Provider Business Mailing Address
First Line	:	6003 BON TERRA DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-3803
Country	:	US
Telephone Number	:	512-981-8051
Fax Number	:	888-616-1651

Provider Business Practice Location Address
First Line	:	6003 BON TERRA DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-3803
Country	:	US
Telephone Number	:	512-981-8051
Fax Number	:	888-616-1651

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2008
Last Update Date	:	10/14/2020

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Directions to “ DR. SAM SAWAYA M.D.” Practice Location

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