Healthcare Provider Details

I. General information

NPI: 1295630598
Provider Name (Legal Business Name): MS. JUANA YASMIN SANTIAGO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5251 FM 2920 RD
SPRING TX
77388-3004
US

IV. Provider business mailing address

7218 VILLAGE OAK DR
LIVE OAK TX
78233-3214
US

V. Phone/Fax

Practice location:
  • Phone: 281-353-2982
  • Fax:
Mailing address:
  • Phone: 713-314-0078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number45758
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: