Provider Demographics
NPI:1740933787
Name:SANTIAGO, MELINDA ANN (RPH)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:ANN
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2756 ABBEY
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-2875
Mailing Address - Country:US
Mailing Address - Phone:956-459-7187
Mailing Address - Fax:
Practice Address - Street 1:1885 E PRICE RD STE B
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-3193
Practice Address - Country:US
Practice Address - Phone:956-554-3532
Practice Address - Fax:956-554-3549
Is Sole Proprietor?:No
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36847183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist