Provider Demographics
NPI:1932154499
Name:SANTOS PT SERVICES, INC.
Entity Type:Organization
Organization Name:SANTOS PT SERVICES, INC.
Other - Org Name:SOUTH LAREDO REHAB SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:M
Authorized Official - Middle Name:ANGELA
Authorized Official - Last Name:SANTOS-GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:956-712-0770
Mailing Address - Street 1:4205 BOB BULLOCK HIGHWAY
Mailing Address - Street 2:LOOP 20, SUITE 14
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046
Mailing Address - Country:US
Mailing Address - Phone:956-712-0770
Mailing Address - Fax:956-712-0776
Practice Address - Street 1:4205 BOB BULLOCK HIGHWAY
Practice Address - Street 2:LOOP 20, SUITE 14
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046
Practice Address - Country:US
Practice Address - Phone:956-712-0770
Practice Address - Fax:956-712-0776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1068369225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F1832Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER
TX00882ZMedicare ID - Type UnspecifiedGROUP NUMBER