MEDICARE: DR. TERRI-ANN PATRICIA SAMUELS 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	207VF0040X	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	N7746	TX

General Provider Information

NPI Number	:	1275717431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRI-ANN PATRICIA SAMUELS M.D.

Provider Business Mailing Address
First Line	:	2171 UNIVERSITY BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1218
Country	:	US
Telephone Number	:	832-831-0362
Fax Number	:	832-995-5874

Provider Business Practice Location Address
First Line	:	6750 WEST LOOP S STE 1060
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77401-4119
Country	:	US
Telephone Number	:	832-831-0362
Fax Number	:	866-313-7527

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

Provider Enumeration Date	:	12/24/2007
Last Update Date	:	11/21/2022

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