Provider Demographics
NPI:1013443407
Name:SANTILLANO, ELSA (OTR)
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:
Last Name:SANTILLANO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 N ZARAGOZA RD
Mailing Address - Street 2:SUITE A-12
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-7975
Mailing Address - Country:US
Mailing Address - Phone:915-921-6881
Mailing Address - Fax:915-921-6882
Practice Address - Street 1:1510 N ZARAGOZA RD
Practice Address - Street 2:SUITE A-12
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7975
Practice Address - Country:US
Practice Address - Phone:915-921-6881
Practice Address - Fax:915-921-6882
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist