Provider Demographics
NPI:1548244833
Name:SANTANA, DIXON (MD)
Entity Type:Individual
Prefix:DR
First Name:DIXON
Middle Name:
Last Name:SANTANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5865
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79408-5865
Mailing Address - Country:US
Mailing Address - Phone:806-743-2898
Mailing Address - Fax:806-743-2787
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:SUITE 3A112
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0002
Practice Address - Country:US
Practice Address - Phone:806-743-2373
Practice Address - Fax:806-743-2113
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41659208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137264101OtherFIRSTCARE COMMERCIAL
TX8M1170OtherHMO BLUE
TX165435201Medicaid
TX165435202Medicaid
TX8G0354OtherBC/BS
TX137264100Medicaid
NMB016OtherTRIWEST
OK200024250AMedicaid
NM201045594OtherPRESBYTERIAN COMMERCIAL
NM201045594Medicaid
NM70982261Medicaid