Provider Demographics
NPI:1790973311
Name:ARTHUR DWAYNE SANTOS, M.D. P.A.
Entity Type:Organization
Organization Name:ARTHUR DWAYNE SANTOS, M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:DWAYNE
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-794-8853
Mailing Address - Street 1:1420 LOGAN AVE
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-4600
Mailing Address - Country:US
Mailing Address - Phone:956-794-8853
Mailing Address - Fax:956-795-4744
Practice Address - Street 1:1420 LOGAN AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-4600
Practice Address - Country:US
Practice Address - Phone:956-794-8853
Practice Address - Fax:956-795-4744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1044174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1598787004OtherNPI
TXA92296OtherUPIN
TX8683B6Medicare UPIN