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NPI Code Detail

MEDICARE: DR. ALFRED AUGUSTINE SANTOS MD

MEDICARE:  DR. ALFRED AUGUSTINE SANTOS  MD
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
1208600000XSurgery PhysicianK8470TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00710648OTHERTXMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
38BW827OTHERTXBCBS

General Provider Information

NPI Number : 1518065937
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALFRED AUGUSTINE SANTOS MD
Provider Business Mailing Address
First Line : PO BOX 2051
Second Line :
City : DECATUR
State : TX
Zip : 76234-6156
Country : US
Telephone Number : 940-393-6370
Fax Number :
Provider Business Practice Location Address
First Line : 9525 GREENVILLE AVE
Second Line :
City : DALLAS
State : TX
Zip : 75243-4116
Country : US
Telephone Number : 940-393-6370
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 06/19/2015

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