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General NPI Number Information
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NPI Number | 1467376947
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Entity Type | Individual
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Provider Name | JADE DELOS SANTOS
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Gender | Female
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 8050 E HIGHWAY 191
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City | ODESSA
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State | TX
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Zip | 79765-8607
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Country | US
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Telephone | 432-685-2110
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Fax |
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Provider Business Mailing Address
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Address Line | 6612 CROWN POINT CT
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City | MIDLAND
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State | TX
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Zip | 79706-2234
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1221250
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License Number State | TX
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