Provider Demographics
NPI:1356510671
Name:SANTO CHIROPRACTIC NEUROLOGY CENTER, INC.
Entity Type:Organization
Organization Name:SANTO CHIROPRACTIC NEUROLOGY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANTO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:903-534-7095
Mailing Address - Street 1:6004 S BROADWAY AVE
Mailing Address - Street 2:SUITE # 200
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-4423
Mailing Address - Country:US
Mailing Address - Phone:903-534-7095
Mailing Address - Fax:903-534-7094
Practice Address - Street 1:6004 S BROADWAY AVE
Practice Address - Street 2:SUITE # 200
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-4423
Practice Address - Country:US
Practice Address - Phone:903-534-7095
Practice Address - Fax:903-534-7094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2698111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601005OtherBLUE CROSS BLUE SHIELD