Provider Demographics
NPI:1962798843
Name:SAMII, MARK SEPEHR (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:SEPEHR
Last Name:SAMII
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 122539
Mailing Address - Street 2:DEPT 2539
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75312-2539
Mailing Address - Country:US
Mailing Address - Phone:337-480-8900
Mailing Address - Fax:337-480-8901
Practice Address - Street 1:2750 ASTER ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8824
Practice Address - Country:US
Practice Address - Phone:337-480-8900
Practice Address - Fax:337-480-8901
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2014-10-02
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Provider Licenses
StateLicense IDTaxonomies
PAMT200512207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine