Individual
KEESHA SHARAY SANTORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2010 MOORES LN STE 108, TEXARKANA, TX 75503-4645
(469) 912-1006
Mailing address
502 COUNTY ROAD 3662, QUEEN CITY, TX 75572-5302
(469) 912-1006
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
MI
1744P3200X
Prosthetics Case Management
Primary
1303336
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1303336
TEXAS DEPARTMENT OF LICENSING & REGISTRATION
TX
Enumeration date
08/24/2015
Last updated
02/28/2025
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