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Sam Edwin Rolon

Family Medicine

Allopathic & Osteopathic Physicians

8558 Creekside Forest Dr Bldg B-100, The Woodlands, TX 77375-2175

PECOS Enrollment

This provider is enrolled in PECOS as SAM ROLON.

Based on the most recent information from CMS, provider Sam Edwin Rolon is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1962616706
Provider Type
Individual
Full Name
Rolon, Sam Edwin
Credential
D.O.

Gender
Male
Sole Proprietor
No
Enumeration Date
5/10/2007
Last Updated
12/6/2023

Contact Information

Practice Location

8558 Creekside Forest Dr Bldg B-100, The Woodlands, TX 77375-2175

(832) 534-7700

Unlisted Fax

Mailing Location

10857 Kuykendahl Rd Ste 130, Spring, TX 77382-2936

(936) 266-4150

(936) 266-4159

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License M5472 Texas

Provider Identifiers

ID	Description	Issuer
ID 188396901	Description Medicaid	Issuer Unlisted Texas
ID 8AK400	Description Other	Issuer BCBSTX Texas

Sam Edwin Rolon

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Martin, Earl E

Ellison-Hodges, Chante Monique

Wanner Mht Llc

Texas Lone Star Family Medicine, P.A.

Huynh, Hung C

Michael G Casagrande Md Pa

Brock, Sonya L

Cotton D. Feray, M.D., A Professional Association

Demattia, Candice Martin

Descant, Emanuel Paul