Provider Demographics
NPI:1346303955
Name:SANTOS, ABISOLA (PT, MBA)
Entity Type:Individual
Prefix:
First Name:ABISOLA
Middle Name:
Last Name:SANTOS
Suffix:
Gender:F
Credentials:PT, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19950 HUEBNER RD
Mailing Address - Street 2:APARTMENT 1101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3292
Mailing Address - Country:US
Mailing Address - Phone:210-957-1651
Mailing Address - Fax:
Practice Address - Street 1:2 TOWERS PARK LN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-6410
Practice Address - Country:US
Practice Address - Phone:210-841-7789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2011-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1161150225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist