Individual
RAUL A SANTOS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 W COLLEGE ST, SUITE 680, GRAPEVINE, TX 76051-3580
(817) 912-8400
(817) 912-8410
Mailing address
1600 W COLLEGE ST, SUITE 680, GRAPEVINE, TX 76051-3580
(817) 912-8400
(817) 912-8410
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
M4511
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084143902
—
TX
05
—
184143901
—
TX
05
—
184143903
—
TX
01
—
8CX371
BCBSTX
TX
01
—
8G9672
BCBS
TX
01
—
P00360598
RAILROAD MEDICARE
TX
Enumeration date
08/07/2006
Last updated
09/18/2012
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