Provider Demographics
NPI:1649701798
Name:SANTOMASSIMO, REBECCA (APRN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:SANTOMASSIMO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11212 STATE HWY 151 MEDICAL PLAZA 1
Mailing Address - Street 2:SUITE 240
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-6517
Mailing Address - Country:US
Mailing Address - Phone:210-682-9434
Mailing Address - Fax:210-682-9435
Practice Address - Street 1:3303 ROGERS RD
Practice Address - Street 2:SUITE 120
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3687
Practice Address - Country:US
Practice Address - Phone:210-520-5040
Practice Address - Fax:210-520-5232
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP133348363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care