Provider Demographics
NPI:1891892782
Name:SANTOS, RAY ERIC (MD)
Entity Type:Individual
Prefix:MR
First Name:RAY
Middle Name:ERIC
Last Name:SANTOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18100 ST JOHN DR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3653
Mailing Address - Country:US
Mailing Address - Phone:281-333-2727
Mailing Address - Fax:281-333-2828
Practice Address - Street 1:18100 ST JOHN DR
Practice Address - Street 2:SUITE 230
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3653
Practice Address - Country:US
Practice Address - Phone:281-333-2727
Practice Address - Fax:281-333-2828
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2755174400000X, 207X00000X
FLME68569174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134235401Medicaid
TXRR200034229OtherMEDICARE RR
TX0070CUOtherBLUE CROSS BLUE SHIELD
TXE88606Medicare UPIN
TXRR200034229OtherMEDICARE RR
TX134235401Medicaid