Provider Demographics
NPI:1508045543
Name:SANTA MARIA, DANIEL LUIGI (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:LUIGI
Last Name:SANTA MARIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SPURS LN
Mailing Address - Street 2:STE 300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1679
Mailing Address - Country:US
Mailing Address - Phone:210-699-8326
Mailing Address - Fax:210-561-7121
Practice Address - Street 1:21 SPURS LN
Practice Address - Street 2:STE 300
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1679
Practice Address - Country:US
Practice Address - Phone:210-699-8326
Practice Address - Fax:210-561-7121
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM75932081S0010X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX189393505Medicaid
12236521OtherCAQH
TX8CT868OtherBCBS
TXTXB136607Medicare PIN
TXP01032484Medicare PIN