Organization Active NPI

Samin Professional Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1902495799
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SAMIN PROFESSIONAL SERVICES LLC
Practice address
17754 Preston Rd Ste 100
Dallas, TX 75252-5638
Phone
(214) 837-8875
Fax
(774) 209-4472
NPI assigned
Jan 15, 2021
Last updated
Jan 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Authorized official

Name
Inemeset Sampson, MSN, APRN, PMHNP-BC,
Title
Owner
Phone
(281) 683-2401

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

17754 Preston Rd Ste 100
Dallas, TX 75252-5638

Mailing address

17754 Preston Rd Ste 100
Dallas, TX 75252-5638
Phone (214) 837-8875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210122000127 TX Part B Supplier - Clinic/Group Practice 1557775178 Receives reassigned benefits from 1 practitioner
Practice locations: Dallas, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2322001Samin Professional Services LLC17754 Preston Rd Ste 100, Dallas, TX 75252Certificate of waiverApr 13, 2027

National Provider Directory

National Provider Directory

Locations

17754 Preston Rd
Ste 100
Dallas, TX 75252
Phone (972) 445-4134

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767916800000",
    "number": "1902495799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17754 PRESTON RD STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525638",
            "telephone_number": "214-837-8875",
            "fax_number": "774-209-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17754 PRESTON RD STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525638",
            "telephone_number": "214-837-8875",
            "fax_number": "774-209-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMIN PROFESSIONAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-15",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A",
        "authorized_official_last_name": "SAMPSON",
        "authorized_official_first_name": "INEMESET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-683-2401",
        "authorized_official_credential": "MSN, APRN, PMHNP-BC,"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.