Provider Demographics
NPI:1255660916
Name:SANTOS, BRENDA ELAINE (PA)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:ELAINE
Last Name:SANTOS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:10950 RESOURCE PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6158
Mailing Address - Country:US
Mailing Address - Phone:281-484-5587
Mailing Address - Fax:281-484-1785
Practice Address - Street 1:10950 RESOURCE PKWY STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6158
Practice Address - Country:US
Practice Address - Phone:281-484-5587
Practice Address - Fax:281-484-1785
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2024-04-16
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX285710401Medicaid
TX285710401Medicaid