Active NPI
Diana Tressa Samuel, M.D.
- Psychiatry Physician
- Austin, TX
National Provider Identifier
1154540862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- N4061
- Practice address
- 11615 Angus Rd
Suite 225
Austin, TX 78759-4078 - Phone
- (512) 372-4554
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | N4061 | TX | |
| Psychiatry Physician | 2084P0800X | N4061 | TX | Primary |
Addresses
Primary practice location
11615 Angus Rd
Suite 225
Austin, TX 78759-4078
Mailing address
5717 Tribune Way
Plano, TX 75094-4505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332288000000",
"number": "1154540862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5717 TRIBUNE WAY",
"city": "PLANO",
"state": "TX",
"postal_code": "750944505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11615 ANGUS RD",
"address_2": "SUITE 225",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787594078",
"telephone_number": "512-372-4554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUEL",
"first_name": "DIANA",
"middle_name": "TRESSA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2012-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "TX",
"license": "N4061",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "N4061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.