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General NPI Number Information
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NPI Number | 1871656298
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Entity Type | Individual
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Provider Name | GINA THERESA DESANTO MD
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Gender | Female
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 8911 N CAPITAL OF TEXAS HWY STE 1110
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City | AUSTIN
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State | TX
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Zip | 78759-7203
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Country | US
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Telephone | 737-226-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 8911 N CAPITAL OF TEXAS HWY STE 1110
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City | AUSTIN
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State | TX
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Zip | 78759-7203
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2023-03172
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35C.000862
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | K2680
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 328122
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License Number State | LA
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