Doctor Name: | SAMANTHA MERRY |
NPI Number: | 1215359310 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNIM |
License Number: | CNIM2768 |
Business Practice Address: | 207a Black Oak Dr Angleton, TX - 775159464 |
Business Phone Number: | 9792489890 |
Business Fax Number: | |
Mailing Address: | 207a Black Oak Dr, ANGLETON |
State: | TX |
Postal Code: | 775159464 |
Phone Number: | 9792489890 |
Fax Number: | |
NPI Enumeration Date: | 01/09/2014 |
NPI Last Update Date: | 01/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246ZE0600X |
License Number: | CNIM2768 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Specialist/Technologist, Other |
Taxonomy Specialization: | Electroneurodiagnostic |
Taxonomy Definition: |