Provider Demographics
NPI:1861712382
Name:SAMIRAN K DAS MD PA
Entity type:Organization
Organization Name:SAMIRAN K DAS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMIRAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:DAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-936-1014
Mailing Address - Street 1:PO BOX 58664
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77258-8664
Mailing Address - Country:US
Mailing Address - Phone:281-333-1062
Mailing Address - Fax:281-335-4529
Practice Address - Street 1:2045 SPACE PARK DR
Practice Address - Street 2:STE. 290
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-6304
Practice Address - Country:US
Practice Address - Phone:281-333-1062
Practice Address - Fax:281-335-4529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-07
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4752207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty