Provider Demographics
NPI:1972000461
Name:SAMARRAI, SAM ALEXANDER (MD)
Entity type:Individual
Prefix:MR
First Name:SAM
Middle Name:ALEXANDER
Last Name:SAMARRAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:SAM
Other - Middle Name:HUSSAM SADIO
Other - Last Name:AL-SAMRRAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2027 S 61ST ST STE 120
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-6817
Mailing Address - Country:US
Mailing Address - Phone:254-314-8990
Mailing Address - Fax:254-566-5232
Practice Address - Street 1:2027 S 61ST ST STE 120
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-6817
Practice Address - Country:US
Practice Address - Phone:254-314-8990
Practice Address - Fax:254-566-1357
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME152025207Q00000X
TXV6097207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLYDQK6OtherFLORIDA BLUE
FL111404100Medicaid