Organization Active NPI

Sam'S Medical Center PLLC

  • Internal Medicine Physician
  • Richardson, TX
National Provider Identifier
1962849372
Registry record updated May 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SAM'S MEDICAL CENTER PLLC
Practice address
2701 Berrywood CT
Richardson, TX 75082-3803
Phone
(972) 808-0421
NPI assigned
May 24, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2013

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

Authorized official

Name
Dr. Sam S Abraham, MDNPI 1831349448
Title
Owner
Phone
(972) 808-0421

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2701 Berrywood CT
Richardson, TX 75082-3803

Mailing address

2701 Berrywood CT
Richardson, TX 75082-3803
Phone (972) 808-0421

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130911000200 TX Part B Supplier - Clinic/Group Practice 6901040005 Receives reassigned benefits from 1 practitioner
Practice locations: Richardson, TX

National Provider Directory

National Provider Directory

Locations

3617 Shire Blvd
Ste 100
Richardson, TX 75082
Phone (214) 216-1359

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369353600000",
    "number": "1962849372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 BERRYWOOD CT",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823803",
            "telephone_number": "972-808-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 BERRYWOOD CT",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823803",
            "telephone_number": "972-808-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM'S MEDICAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-24",
        "last_updated": "2013-05-24",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-808-0421",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.