Samuel Terrence Poulos, M.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

BP10056859 Issued in TX

Practice address

601 E 15TH St
Ut Austin Dell Medical School Internal Medicine
Austin, TX 78701-1930

Phone

(512) 324-8355

NPI assigned

May 26, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1093163321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E 15TH ST",
            "address_2": "UT AUSTIN DELL MEDICAL SCHOOL INTERNAL MEDICINE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011930",
            "telephone_number": "512-324-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E 15TH ST",
            "address_2": "UT AUSTIN DELL MEDICAL SCHOOL INTERNAL MEDICINE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011930",
            "telephone_number": "512-324-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULOS",
        "first_name": "SAMUEL",
        "middle_name": "TERRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-26",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10056859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallory Louise Potts, DC
• Wanda Buffaloe Potts, RN, RNFA
• Anjana Poudel
• Fabrice Lionel Pougoue Ngomsi
• Rebecca Poulos
• Pamela Poulter
• Amanda Lynn Pouncy-Ross, LCSW
• Amy Powell
• Anna Powell
• Caroline Amanda Powell, RD

• Student in an Organized Health Care Education/Training Program in Austin, TX
• Providers in Austin, TX by specialty
• Student in an Organized Health Care Education/Training Program in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.