Provider Demographics
NPI:1104388826
Name:SAMANTA, ANINDYA (MD)
Entity type:Individual
Prefix:
First Name:ANINDYA
Middle Name:
Last Name:SAMANTA
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 1:5220 80TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2862
Mailing Address - Country:US
Mailing Address - Phone:806-743-2786
Mailing Address - Fax:
Practice Address - Street 1:1700 CURIE DR STE 3800
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2985
Practice Address - Country:US
Practice Address - Phone:915-532-3912
Practice Address - Fax:915-533-8442
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU4917207W00000X, 207WX0107X
NMMD2025-0504207WX0107X
TXBP10071184390200000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program