1851631964 NPI number — SAMANTHA MARIE KINSMAN THWING PA

Table of content: SAMANTHA MARIE KINSMAN THWING PA (NPI 1851631964)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851631964 NPI number — SAMANTHA MARIE KINSMAN THWING PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THWING
Provider First Name:
SAMANTHA
Provider Middle Name:
MARIE KINSMAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KINSMAN
Provider Other First Name:
SAMANTHA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1851631964
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6400 FANNIN ST STE 2070
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77030-1541
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-486-8000
Provider Business Mailing Address Fax Number:
713-486-8088

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
929 GESSNER RD, STE 2410
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77024-2515
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-486-7720
Provider Business Practice Location Address Fax Number:
713-486-7744
Provider Enumeration Date:
02/26/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  PA08345 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)