Individual
CARMEN SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
1110 N CARROLL AVE, SOUTHLAKE, TX 76092-5306
(817) 310-1100
(817) 310-1197
Mailing address
1110 N CARROLL AVE, SOUTHLAKE, TX 76092-5306
(817) 310-1100
(817) 310-1197
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
1120700
TX
Other
Enumeration date
06/01/2023
Last updated
06/01/2023
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