Healthcare Provider Details

I. General information

NPI: 1730732892
Provider Name (Legal Business Name): SAMANTHA ESTES PAC, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMANTHA GIGANTE ATC

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER UNIT 33100
APO AE
09180-3100
US

IV. Provider business mailing address

LANDSTUHL REGIONAL MEDICAL CENTER UNIT 33100
APO AE
09180-3100
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-5762
  • Fax:
Mailing address:
  • Phone: 314-590-5762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PS0010X
TaxonomySports Medicine (Emergency Medicine) Physician
License Number0590262
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1213069
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2026017230
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: