MEDICARE: DR. HUMBERTO ANGEL DE LOS SANTOS M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	TX N7247	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417134867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HUMBERTO ANGEL DE LOS SANTOS M.D

Provider Business Mailing Address
First Line	:	1411 N BECKLEY AVE
Second Line	:	SUITE 356
City	:	DALLAS
State	:	TX
Zip	:	75203-1591
Country	:	US
Telephone Number	:	214-941-0100
Fax Number	:	214-941-7024

Provider Business Practice Location Address
First Line	:	1411 N BECKLEY AVE
Second Line	:	SUITE 356
City	:	DALLAS
State	:	TX
Zip	:	75203-1591
Country	:	US
Telephone Number	:	214-941-0100
Fax Number	:	214-941-7024

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2008
Last Update Date	:	03/24/2015

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