MEDICARE: DANCING DOC LLC

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

General Provider Information

NPI Number	:	1831031020
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANCING DOC LLC

Provider Business Mailing 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	:

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	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TERRI ANN PATRICIA SAMUELS
Credential	:
Telephone Number	:	832-831-0362

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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Directions to “DANCING DOC LLC ” Practice Location

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