Provider Demographics
NPI:1730319716
Name:CHRISTINA DESANTOS MD PA
Entity Type:Organization
Organization Name:CHRISTINA DESANTOS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DESANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-779-1716
Mailing Address - Street 1:5959 GATEWAY BLVD W
Mailing Address - Street 2:STE 120
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-3331
Mailing Address - Country:US
Mailing Address - Phone:915-779-1716
Mailing Address - Fax:915-774-6496
Practice Address - Street 1:1700 N OREGON ST
Practice Address - Street 2:STE 570
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3584
Practice Address - Country:US
Practice Address - Phone:915-225-2455
Practice Address - Fax:915-503-2114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty