Provider Demographics
NPI:1861892184
Name:SANTANA FAMILY CARE PLLC
Entity type:Organization
Organization Name:SANTANA FAMILY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CALUDIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:830-752-0700
Mailing Address - Street 1:2149 EL INDIO HWY
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-5455
Mailing Address - Country:US
Mailing Address - Phone:830-752-0700
Mailing Address - Fax:
Practice Address - Street 1:161 HERITAGE FARMS DR
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-6656
Practice Address - Country:US
Practice Address - Phone:830-752-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty