Mavis Sam

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

16647 Issued in CT

Practice address

4055 Valley View LN Ste 700
Dallas, TX 75244-5045

Phone

(855) 984-5121

NPI assigned

Oct 12, 2026

Last updated

Oct 12, 2026By the provider in NPPES

Sex

Female

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

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

{
    "created_epoch": "1791763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791763200000",
    "number": "1215832043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 VALLEY VIEW LN STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 VALLEY VIEW LN STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445045",
            "telephone_number": "855-984-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAM",
        "first_name": "MAVIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-12",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "16647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sam T. Hamra M.D. P. a.
• Blessy Sam, MSN, APRN, FNP-C
• Caroline E Sam
• Leroy Sam, ATC, LAT, LMT
• Maurine Sam
• Stephany Sam
• Teena Sam, PHARMD
• Sam's Club Optical (Sam's Club Optical 30-8282)
• Sam's Club Optical (Sam's Club Optical 30-8242)
• Sam's East Inc (Sam's Optical 30-8248)

• Adult Health Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Adult Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.