Healthcare Provider Details
I. General information
NPI: 1548307481
Provider Name (Legal Business Name): ISABEL CRISTINA ROJAS SANTAMARIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/31/2007
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5323 HARRY HINES BOULEVARD
DALLAS TX
75390-7208
US
IV. Provider business mailing address
P.O. BOX 845347
DALLAS TX
75284-5347
US
V. Phone/Fax
- Phone: 214-456-8000
- Fax: 214-456-8005
- Phone: 214-456-8000
- Fax: 214-456-8005
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 24526 |
| License Number State | OK |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0206X |
| Taxonomy | Pediatric Gastroenterology Physician |
| License Number | N9945 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | N9945 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: