Prestige MD Concierge PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PRESTIGE MD CONCIERGE PLLC

Practice address

75 Miranda Lambert Way Ste 19
Lindale, TX 75771-3107

Phone

(786) 708-5509

Fax

(903) 202-1314

NPI assigned

May 28, 2025

Last updated

May 28, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mohammad Samiullah, MDNPI 1578025607

Title

Managing Physician

Phone

(903) 253-2717

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mohammad Samiullah, MD

  • Internal Medicine Physician
  • Tyler, TX
  • NPI 1578025607
  NPD Authorized official

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

{
    "created_epoch": "1748390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1730972910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 OAK CREEK BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031260",
            "telephone_number": "903-253-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MIRANDA LAMBERT WAY STE 19",
            "city": "LINDALE",
            "state": "TX",
            "postal_code": "757713107",
            "telephone_number": "786-708-5509",
            "fax_number": "903-202-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE MD CONCIERGE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "SAMIULLAH",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "MANAGING PHYSICIAN",
        "authorized_official_telephone_number": "903-253-2717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lori Nicole Puckett, RPH
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• Internal Medicine Physician in Lindale, TX
• Providers in Lindale, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.