Provider Demographics
NPI:1740226604
Name:DELOS SANTOS, MARIANO D JR (RNFA)
Entity Type:Individual
Prefix:MR
First Name:MARIANO
Middle Name:D
Last Name:DELOS SANTOS
Suffix:JR
Gender:M
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11527 VALLEY PIKE CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-0902
Mailing Address - Country:US
Mailing Address - Phone:281-903-2171
Mailing Address - Fax:
Practice Address - Street 1:11527 VALLEY PIKE CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-0902
Practice Address - Country:US
Practice Address - Phone:281-903-2171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX624425163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant