Provider Demographics
NPI:1750610168
Name:SANTOS, ANTHONY (NP)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:SANTOS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20269
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77225-0269
Mailing Address - Country:US
Mailing Address - Phone:832-355-3938
Mailing Address - Fax:832-355-3019
Practice Address - Street 1:6624 FANNIN ST
Practice Address - Street 2:SUITE 1180
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2312
Practice Address - Country:US
Practice Address - Phone:832-355-3938
Practice Address - Fax:832-355-7299
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX681787363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health