Provider Demographics
NPI:1770870651
Name:SANTIAGO, GENEE N (RPH,PHARMD)
Entity type:Individual
Prefix:
First Name:GENEE
Middle Name:N
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:RPH,PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11311 BANDERA RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-6812
Mailing Address - Country:US
Mailing Address - Phone:210-682-2533
Mailing Address - Fax:210-682-2533
Practice Address - Street 1:11311 BANDERA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-6812
Practice Address - Country:US
Practice Address - Phone:210-682-2533
Practice Address - Fax:210-682-2533
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42515183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist