Provider Demographics
NPI:1346496171
Name:SANTOS, ANNA MARIA (PT)
Entity Type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:MARIA
Last Name:SANTOS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 W GRAMERCY PL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-3157
Mailing Address - Country:US
Mailing Address - Phone:210-367-3567
Mailing Address - Fax:
Practice Address - Street 1:2611 W GRAMERCY PL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-3157
Practice Address - Country:US
Practice Address - Phone:210-367-3567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1182881225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist