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Individual

JOSE SANTANA JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CST

Contact information

Practice address
10317 DALLAM LN, FORT WORTH, TX 76108-4975
(817) 244-3511
Mailing address
10317 DALLAM LN, FORT WORTH, TX 76108-4975
(817) 244-3511

Taxonomy

Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
84215
TX

Other

Enumeration date
03/11/2011
Last updated
03/11/2011
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