Provider Demographics
NPI:1811353642
Name:EUBANKS, SAMANTHA (CNM)
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:
Last Name:EUBANKS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 HILL COUNTRY DR
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-6085
Mailing Address - Country:US
Mailing Address - Phone:830-258-7288
Mailing Address - Fax:830-258-7678
Practice Address - Street 1:2602 SHERWOOD ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76209-1187
Practice Address - Country:US
Practice Address - Phone:940-206-5403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-09
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129604367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife