Provider Demographics
NPI:1447402672
Name:ALFRED A. SANTOS, M.D., P.A.
Entity Type:Organization
Organization Name:ALFRED A. SANTOS, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:AUGUSTINE
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-626-1900
Mailing Address - Street 1:PO BOX 2051
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-6156
Mailing Address - Country:US
Mailing Address - Phone:940-626-1900
Mailing Address - Fax:940-626-1901
Practice Address - Street 1:2000 BEN MERRITT DR
Practice Address - Street 2:SUITE B
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3848
Practice Address - Country:US
Practice Address - Phone:940-626-1900
Practice Address - Fax:940-626-1901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8470208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0014RZOtherBCBS
TXDO8407OtherMEDICARE RAILROAD
TX202586801Medicaid
TXDO8407OtherMEDICARE RAILROAD