SAMANTHA CHILDERS (NPI# 1790837425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790837425 |
| Entity Type | Individual |
| Full Name | SAMANTHA CHILDERS |
| Credential | DPM |
| Practice Address |
351 W. Byron Nelson Blvd Suite 100 Roanoke TX 76262 |
| Mailing Address |
1224 N Highway 377 # 303-151 Roanoke TX 76262-9103 |
| Practice Telephone | 4156022048 |
| Mailing Telephone | 8176747494 |
| Mailing Fax Number | 8558806990 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-09-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
1931 | TX | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 355509601 | 05 | |
| TX | BCBSTX | #8FV228 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1713 S Fm 51, Suite 103, Decatur, TX 762343642 | 9406276976 | 9406273491 |
| 351 W. Byron Nelson Blvd, Suite 100, Roanoke, TX 76262 | 4156022048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902322506 | Samantha Marie Childers | Occupational Therapist | 851 Professional Park Dr, Clarksville, TN 37040-5257 | 2017-08-16 |
| 1467972711 | Samantha Childers | Physician Assistant | 2420 Argillite Rd Ste B, Flatwoods, KY 41139-1972 | 2017-06-27 |
| Street Address |
351 W. BYRON NELSON BLVD SUITE 100 |
| City | ROANOKE |
| State | TX |
| Zip Code | 76262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861025611 | Freeform Chiropractic Trophy Club LLC | Chiropractor | 2240 Sh 114, Suite 650, Trophy Club, TX 76262 | 2020-02-20 |
| 1932748498 | Legacy Physical Therapy and Wellness | Physical Therapist | 351 N Byron Nelson Blvd, Suite 110, Roanoke, TX 76262 | 2020-01-02 |
| 1497399687 | Roanoke Foot & Ankle Institute, Pllc | Podiatrist | 351 W Byron Nelson Blvd, Suite 100, Roanoke, TX 76262 | 2019-10-31 |
| 1710470810 | Maria Guadalupe Madera | Dentist | 5000 Highway 114, Unit 130, Northlake, TX 76262 | 2018-06-13 |
| 1912414251 | 6 Day Dental Group - Roanoke, Pllc | Clinic/Center | 200 Tx-114, Roanoke, TX 76262 | 2018-01-09 |
| 1144746561 | Lone Star Neurosurgical Assistants | Physician Assistant | 1270 Casa Bella Ct, Westlake, TX 76262 | 2017-08-17 |
| 1710347562 | Randolph R West Dds Pllc | Dentist | 295 W. Byron Nelson Blvd, Ste 304, Roanoke, TX 76262 | 2016-03-07 |
| 1912367228 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 35 Arta Dr, Westlake, TX 76262 | 2016-02-29 |
| 1952760050 | Roanoke Dental Group,pc | Dentist | 1320 N Hwy 377 Suite 100, Roanoke, TX 76262 | 2016-02-17 |
| 1942683115 | Fatima Naurose Siraj | Dentist | 860 East Highway 114 Ideal Dental, Suite 200, Roanoke, TX 76262 | 2015-07-07 |
| Find all providers in zip 76262 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497399687 | Roanoke Foot & Ankle Institute, Pllc | Podiatrist | 351 W Byron Nelson Blvd, Suite 100, Roanoke, TX 76262 | 2019-10-31 |
| 1912391293 | Natalie Hoffman | Podiatrist | 60 Summerfield Ct Ste 102, Roanoke, VA 24019-4579 | 2015-03-24 |
| 1508837402 | Charles M Zelen | Podiatrist | 222 Walnut Ave Sw, Roanoke, VA 24016-4723 | 2006-01-30 |
| 1063862035 | Wesley Maurice Leong | Podiatrist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2016-06-20 |
| 1689020703 | Ivan Rubiano | Podiatrist | 222 Walnut Ave Sw, Roanoke, VA 24016-4723 | 2016-05-07 |
| 1508253683 | Blayne Kenneth Patton | Podiatrist | 3 Riverside Cir, Roanoke, VA 24016 | 2015-04-16 |
| 1942560727 | Jordan Zane Tacktill | Podiatrist | 222 Walnut Ave Sw, Roanoke, VA 24016-4723 | 2012-05-25 |
| 1841425600 | Nathan John Young | Podiatrist | 222 Walnut Ave Sw, Roanoke, VA 24016-4723 | 2009-05-22 |
| 1053503961 | David Lamont Nielson | Podiatrist | 222 Walnut Ave Sw, Roanoke, VA 24016-4723 | 2007-08-14 |
| 1497813430 | Advanced Foot and Ankle Center, Pllc | Podiatrist | 1121 S Jefferson St, Roanoke, VA 24016-4703 | 2006-12-04 |
| Find all providers in ROANOKE | ||||
Please comment or provide details below to improve the information on SAMANTHA CHILDERS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.