Provider Demographics
NPI:1609084870
Name:SANTANA, REBECCA (RN)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:SANTANA
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 1:3634 FALCON DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-2718
Mailing Address - Country:US
Mailing Address - Phone:210-438-9357
Mailing Address - Fax:210-438-1977
Practice Address - Street 1:3634 FALCON DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-2718
Practice Address - Country:US
Practice Address - Phone:210-438-9357
Practice Address - Fax:210-438-1977
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0087513747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS50026915Medicaid