MEDICARE: V SAMAVEDI MD PA

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

General Provider Information

NPI Number	:	1659507267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	V SAMAVEDI MD PA

Provider Business Mailing Address
First Line	:	4300 BAY AREA BLVD APT 3614
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-1144
Country	:	US
Telephone Number	:	281-979-9291
Fax Number	:	713-991-7955

Provider Business Practice Location Address
First Line	:	4300 BAY AREA BLVD APT 3614
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-1144
Country	:	US
Telephone Number	:	281-979-9291
Fax Number	:	713-991-7955

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	MS. GRACE GARCIA
Credential	:
Telephone Number	:	713-205-3305

Provider Enumeration Date	:	06/09/2009
Last Update Date	:	06/09/2009

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