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Individual
DR. ROBERTO DE LOS SANTOS
Active
Individual
DR. ROBERTO DE LOS SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
3090
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
213E00000X
TAXONOMY CODE
TX
01
—
2961806229
PECOS PAC ID
TX
05
—
427303902
—
TX
01
—
450684
CMS CERTIFICATION NUMBER MEMORIAL HERMAN NORTHEAST
—
01
—
I20210809001539
PECOS ENROLLMENT ID
TX
Enumeration date
05/13/2018
Last updated
07/21/2022
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