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NPI Code Detail

MEDICARE: SAMANTHA J VIGNERI

MEDICARE: SAMANTHA J VIGNERI
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
1101YP2500XProfessional Counselor
2103TC0700XClinical Psychologist
31041C0700XClinical Social Worker
42084P0800XPsychiatry Physician
52084P0805XGeriatric Psychiatry Physician
6103TH0100XHealth Service Psychologist
7103T00000XPsychologist
8104100000XSocial Worker

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3CB3577OTHERTXRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
200R43ROTHERTXBCBS

General Provider Information

NPI Number : 1073617684
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAMANTHA J VIGNERI
Provider Business Mailing Address
First Line : 24891 HIGHWAY 6
Second Line :
City : HEMPSTEAD
State : TX
Zip : 77445-7747
Country : US
Telephone Number : 800-869-8552
Fax Number : 713-869-8564
Provider Business Practice Location Address
First Line : 24891 HIGHWAY 6
Second Line :
City : HEMPSTEAD
State : TX
Zip : 77445-7747
Country : US
Telephone Number : 800-869-8552
Fax Number : 713-869-8564
Authorized Official
Title or Position : SOLE PROPRIETOR
Name : SAMANTHA J VIGNERI
Credential :
Telephone Number : 800-869-8552
Provider Enumeration Date : 09/12/2006
Last Update Date : 05/16/2008

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Practice Location Address:
24891 HIGHWAY 6
HEMPSTEAD, TX
77445-7747
Practice Phone: 800-869-8552
Practice Fax: 713-869-8564

Directions to “SAMANTHA J VIGNERI ” Practice Location

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