Provider Demographics
NPI:1528033941
Name:SANTONE, PAMELA (DO)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:SANTONE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 W WHEATLAND RD
Mailing Address - Street 2:PAV III STE#360
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-4418
Mailing Address - Country:US
Mailing Address - Phone:214-947-7325
Mailing Address - Fax:214-884-4749
Practice Address - Street 1:4560 LAKE RIDGE PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052
Practice Address - Country:US
Practice Address - Phone:972-263-5272
Practice Address - Fax:972-263-3488
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8A7075OtherBC/BS
TX146002401Medicaid
TX8466M1Medicare PIN