MEDICARE: ASIYAMARY PM&R CONSULTANCY PLLC

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	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1164305215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASIYAMARY PM&R CONSULTANCY PLLC

Provider Business Mailing Address
First Line	:	4701 14TH ST APT 14101
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-7342
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4701 14TH ST APT 14101
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-7342
Country	:	US
Telephone Number	:	646-388-1358
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JOSHANE SAMSON
Credential	:
Telephone Number	:	954-686-8426

Provider Enumeration Date	:	07/28/2025
Last Update Date	:	02/02/2026

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