Provider Demographics
NPI:1568525079
Name:SANTIAGO, KAREN A (RN)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:A
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 YUCCA CIR
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-8016
Mailing Address - Country:US
Mailing Address - Phone:254-698-1903
Mailing Address - Fax:
Practice Address - Street 1:819 E HIGHWAY 190
Practice Address - Street 2:
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522-2259
Practice Address - Country:US
Practice Address - Phone:254-542-3080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX715857261QM1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient