Healthcare Provider Details

I. General information

NPI: 1235277864
Provider Name (Legal Business Name): ARIEL PABLO SANTOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2007
Last Update Date: 03/07/2023
Certification Date: 11/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 4TH ST DEPARTMENT OF SURGERY - TTUHSC
LUBBOCK TX
79430-1786
US

IV. Provider business mailing address

3601 4TH ST DEPT OF
LUBBOCK TX
79430-0002
US

V. Phone/Fax

Practice location:
  • Phone: 67-437-8748
  • Fax: 806-743-1225
Mailing address:
  • Phone: 806-743-7874
  • Fax: 806-743-1225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberQ6277
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberQ6277
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberQ6277
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: