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General NPI Number Information
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NPI Number | 1427232693
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Entity Type | Organization
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Legal Business Name | ANGEL SANTIAGO JR., D.C., P.A.
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 12/24/2007
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Provider Practice Location Address
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Address Line | 650 S EDMONDS LN SUITE 106
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City | LEWISVILLE
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State | TX
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Zip | 75067-3511
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Country | US
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Telephone | 972-956-8297
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Fax | 972-956-8257
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Provider Business Mailing Address
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Address Line | 650 S. EDMONDS LANE SUITE 106
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City | LEWISVILLE
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State | TX
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Zip | 75067-3554
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Country | US
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Telephone | 972-956-8297
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Fax | 972-956-8257
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANGEL SANTIAGO JR.
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Credential | D.C.
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Telephone | 972-956-8297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 10074
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License Number State | TX
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