Individual provider Active NPI

Steven Jeffrey Samson, PA-C

  • Medical Physician Assistant
  • Corpus Christi, TX
National Provider Identifier
1063448165
Registry record updated Jul 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA07401 Issued in TX
Practice address
2606 Hospital Blvd
7TH Floor West
Corpus Christi, TX 78405-1804
Phone
(361) 902-4387
Fax
(361) 902-6571
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1054332 TX
Medical Physician Assistant 363AM0700X PA07401 TX Primary

Addresses

Primary practice location

2606 Hospital Blvd
7TH Floor West
Corpus Christi, TX 78405-1804

Mailing address

919 Hidden RDG
6TH Floor
Irving, TX 75038-3813
Phone (469) 282-2711

Other identifiers 1

IdentifierTypeStateIssuer
333552301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1054332TXMDMedical Physician Assistant
PA07401TXMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1063448165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 HIDDEN RDG",
            "address_2": "6TH FLOOR",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383813",
            "telephone_number": "469-282-2711",
            "fax_number": "469-282-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 HOSPITAL BLVD",
            "address_2": "7TH FLOOR WEST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784051804",
            "telephone_number": "361-902-4387",
            "fax_number": "361-902-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMSON",
        "first_name": "STEVEN",
        "middle_name": "JEFFREY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "1054332",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA07401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "333552301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.