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General NPI Number Information
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NPI Number | 1134233976
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Entity Type | Individual
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Provider Name | MARCIA SANTOS GENTA M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 08/23/2007
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Provider Practice Location Address
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Address Line | 221 W COLORADO BLVD PAV 1 STE #422
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City | DALLAS
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State | TX
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Zip | 75208-2363
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Country | US
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Telephone | 214-941-0198
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Fax | 214-941-2380
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Provider Business Mailing Address
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Address Line | 11111 EASTVIEW CIR
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City | DALLAS
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State | TX
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Zip | 75230-3531
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Country | US
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Telephone | 214-234-0674
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | J4146
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License Number State | TX
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