Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | M8315 | TX |
Y | 208600000X | Surgeon | M8315 | TX |
N | 2086X0206X | Surgical Oncologist | M8315 | TX |
NPI | 1124213400 |
---|---|
Provider Name | Dr. Alfredo Alejandro Santillan-Gomez |
First Address | Dallas, TX 75391-1230 |
Second Address | San Antonio, TX 78240-5251 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2007 |
Last Update Date | 26/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
188777003 | (05) | TX |
206018801 | (05) | TX |
206018802 | CSHCN (01) | TX |
P01587661 | RAILROAD (01) | TX |