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General NPI Number Information
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NPI Number | 1972038107
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Entity Type | Individual
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Provider Name | ASTINI SANJOTO DE LA CRUZ M.D
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Gender | Female
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Dates
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Enumeration Date | 04/25/2017
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Last Update Date | 12/31/2021
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Provider Practice Location Address
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Address Line | 15882 CHAMPION FOREST DR
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City | SPRING
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State | TX
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Zip | 77379-7141
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Country | US
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Telephone | 281-783-8162
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Fax |
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Provider Business Mailing Address
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Address Line | 5749 SAN FELIPE ST
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City | HOUSTON
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State | TX
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Zip | 77057-3101
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Country | US
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Telephone | 281-783-8162
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Fax | 713-439-7995
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R9426
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License Number State | TX
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