Provider Demographics
NPI:1063416717
Name:HORTON, SAMMY JOE (MD)
Entity type:Individual
Prefix:DR
First Name:SAMMY
Middle Name:JOE
Last Name:HORTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2078
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-6156
Mailing Address - Country:US
Mailing Address - Phone:940-539-2501
Mailing Address - Fax:940-626-3811
Practice Address - Street 1:609 MEDICAL CENTER DR STE 2400
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3803
Practice Address - Country:US
Practice Address - Phone:940-539-2501
Practice Address - Fax:940-626-3811
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0278207RG0100X
NH18249207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPENDINGOtherBCBS OF TEXAS
TXPENDINGMedicaid
TX155474302Medicaid
TX155474302Medicaid