Provider Demographics
NPI:1790276400
Name:DANIEL R. SANTILLANO MD. PLLC
Entity Type:Organization
Organization Name:DANIEL R. SANTILLANO MD. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:SANTILLANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-326-0398
Mailing Address - Street 1:1150 N LOOP 1604 W # 108-402
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-4552
Mailing Address - Country:US
Mailing Address - Phone:210-326-0398
Mailing Address - Fax:210-558-6289
Practice Address - Street 1:1150 N LOOP 1604 W # 108-402
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-4552
Practice Address - Country:US
Practice Address - Phone:210-326-0398
Practice Address - Fax:210-558-6289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-29
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center