Provider Demographics
NPI:1306161211
Name:ROBARE, SAMANTHA JANE (MD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:JANE
Last Name:ROBARE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SAMANTHA
Other - Middle Name:JANE
Other - Last Name:ROBARE-STOUT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10547 FRY RD
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5348
Mailing Address - Country:US
Mailing Address - Phone:832-834-3349
Mailing Address - Fax:
Practice Address - Street 1:10547 FRY RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-5348
Practice Address - Country:US
Practice Address - Phone:832-834-3349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4806207N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program