Healthcare Provider Details

I. General information

NPI: 1588955405
Provider Name (Legal Business Name): MELISSA ANNE LAYNO SANTILLAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELISSA ANNE ABESAMIS LAYNO M.D.

II. Dates (important events)

Enumeration Date: 04/26/2011
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21214 NORTHWEST FREEWAY
CYPRESS TX
77429
US

IV. Provider business mailing address

12700 PARK CENTRAL DR STE 900
DALLAS TX
75251
US

V. Phone/Fax

Practice location:
  • Phone: 832-912-3800
  • Fax:
Mailing address:
  • Phone: 214-860-6038
  • Fax: 972-499-1967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberQ3396
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL3477R
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD33607
License Number StateAL
# 5
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberQ3396
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: