Provider Demographics
NPI:1255471223
Name:TORRES, ROLANDO SANTILLAN (PT)
Entity Type:Individual
Prefix:
First Name:ROLANDO
Middle Name:SANTILLAN
Last Name:TORRES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6243 FAIRMONT PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-4045
Mailing Address - Country:US
Mailing Address - Phone:713-553-1304
Mailing Address - Fax:
Practice Address - Street 1:6243 FAIRMONT PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-4045
Practice Address - Country:US
Practice Address - Phone:713-553-1304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10611661225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist