Provider Demographics
NPI:1235277864
Name:SANTOS, ARIEL PABLO (MD)
Entity Type:Individual
Prefix:DR
First Name:ARIEL
Middle Name:PABLO
Last Name:SANTOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 4TH ST DEPT OF
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-0002
Mailing Address - Country:US
Mailing Address - Phone:806-743-7874
Mailing Address - Fax:806-743-1225
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:DEPARTMENT OF SURGERY - TTUHSC
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-1786
Practice Address - Country:US
Practice Address - Phone:067-437-8748
Practice Address - Fax:806-743-1225
Is Sole Proprietor?:No
Enumeration Date:2007-02-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ62772086S0127X, 2086S0102X, 208600000X, 2086S0127X, 208600000X, 2086S0102X
PAMD4469072086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX352448002Medicaid
PAMD446907OtherPENNSYLVANIA LICENSE
TX352448001Medicaid
NM16452577Medicaid
OK200613580 AMedicaid
PAFS3556923OtherDEA
OK200613580 AMedicaid