Provider Demographics
NPI:1841848702
Name:SANTOS, PAZ CIELO
Entity type:Individual
Prefix:MRS
First Name:PAZ
Middle Name:CIELO
Last Name:SANTOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8321 ROCK CANYON CT
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-1888
Mailing Address - Country:US
Mailing Address - Phone:817-370-8480
Mailing Address - Fax:
Practice Address - Street 1:8321 ROCK CANYON CT
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-1888
Practice Address - Country:US
Practice Address - Phone:817-370-8480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider