Individual provider Active NPI

Samantha G Edwin, PA-C

  • Physician Assistant
  • Eagle Pass, TX
National Provider Identifier
1063377299
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19836 Issued in TX
Practice address
1175 Eidson Rd
Eagle Pass, TX 78852-5403
Phone
(830) 757-6946
NPI assigned
Dec 19, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA19836 TX Primary

Addresses

Primary practice location

1175 Eidson Rd
Eagle Pass, TX 78852-5403

Mailing address

2525 N Veterans Blvd
Eagle Pass, TX 78852-3302
Phone (830) 773-8917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260304000774 TX Practitioner - Physician Assistant 2567944010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2525 N Veterans Blvd
Eagle Pass, TX 78852-3302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA19836TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Centers Physician Assistant CurrentSince Feb 2, 2026 Accepting new patients
United Medical Centers Physician Assistant CurrentSince Feb 2, 2026 Accepting new patients

Locations

1175 Eidson Rd
Eagle Pass, TX 78852
Phone (830) 757-6946

2525 N Veterans Blvd
Eagle Pass, TX 78852
Phone (830) 773-5358

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1766102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1063377299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 N VETERANS BLVD",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788523302",
            "telephone_number": "830-773-8917",
            "fax_number": "855-697-4623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 EIDSON RD",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788525403",
            "telephone_number": "830-757-6946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWIN",
        "first_name": "SAMANTHA",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-19",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Pass, TX

Sources for this page

Verify at the official NPI Registry.