Sam Baber, DDS
Individual provider Active NPI Dentist · MC Gregor, TX
NPI 1013238435 · NPPES record last updated Aug 13, 2012
Key facts
- NPI
- 1013238435
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 25535 (TX)
- Practice address
- 27487 W Highway 84
MC Gregor, TX 76657-3717 - Phone
- (254) 848-9566
- NPI assigned
- Jun 21, 2010
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25535 | TX | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 25535 | TX | Yes |
Addresses
Primary practice location
27487 W Highway 84
MC Gregor, TX 76657-3717
Mailing address
27487 W Highway 84
MC Gregor, TX 76657-3717
Phone (254) 848-9566
Other providers in MC Gregor, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.