Provider Demographics
NPI:1043625957
Name:SANTOS, ABEGAIL (PTA)
Entity Type:Individual
Prefix:
First Name:ABEGAIL
Middle Name:
Last Name:SANTOS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 580526
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77258-0526
Mailing Address - Country:US
Mailing Address - Phone:281-837-7571
Mailing Address - Fax:281-664-3789
Practice Address - Street 1:910 N HIGHWAY 146
Practice Address - Street 2:STE. A
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-2252
Practice Address - Country:US
Practice Address - Phone:281-837-7571
Practice Address - Fax:281-664-3789
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2098911225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant