MEDICARE: SAMIYYAH SABUR LPC-S

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	101Y00000X	Counselor	TPMC3412	FL
2	101Y00000X	Counselor	72204	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	72204	OTHER	TX	STATE OF TEXAS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	TPMC3412	OTHER	FL	STATE OF FLORIDA

General Provider Information

NPI Number	:	1124422134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMIYYAH SABUR LPC-S

Provider Business Mailing Address
First Line	:	PO BOX 22273
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77227-2273
Country	:	US
Telephone Number	:	346-814-4811
Fax Number	:

Provider Business Practice Location Address
First Line	:	712 WILCREST DR STE 2082
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-1348
Country	:	US
Telephone Number	:	346-814-4811
Fax Number	:	832-201-9827

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

Provider Enumeration Date	:	10/20/2014
Last Update Date	:	08/01/2023

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Directions to “ SAMIYYAH SABUR LPC-S” Practice Location

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