Provider Demographics
NPI:1902844509
Name:SUKKAR, SAMIR (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:
Last Name:SUKKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SAM
Other - Middle Name:M
Other - Last Name:SUKKAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:14018 AESTHETIC CIR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-2373
Mailing Address - Country:US
Mailing Address - Phone:281-990-8487
Mailing Address - Fax:713-281-2685
Practice Address - Street 1:14018 AESTHETIC CIR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-2373
Practice Address - Country:US
Practice Address - Phone:281-990-8487
Practice Address - Fax:713-481-2685
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ72182086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF90983Medicare UPIN
TX00555QMedicare ID - Type Unspecified