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NPI Code Detail

MEDICARE: ERIC DAVID SANTIAGO

MEDICARE:   ERIC DAVID SANTIAGO
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
1225100000XPhysical Therapist1190830TX

General Provider Information

NPI Number : 1689995508
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC DAVID SANTIAGO
Provider Business Mailing Address
First Line : 1117 CLEAR LAKE CITY BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77062-8102
Country : US
Telephone Number : 832-224-4735
Fax Number : 832-224-4679
Provider Business Practice Location Address
First Line : 1117 CLEAR LAKE CITY BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77062-8102
Country : US
Telephone Number : 832-224-4735
Fax Number : 832-224-4679
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2010
Last Update Date : 08/08/2016

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Directions to “ ERIC DAVID SANTIAGO ” Practice Location

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