Individual
ERVA SANTOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
18511 HIGHLANDER MEDICS ST, FORT BLISS, TX 79906-5327
(718) 360-7472
Mailing address
11400 EDGEMERE BLVD APT 3113, EL PASO, TX 79936-2426
(718) 360-7472
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1072186
—
133V00000X
Registered Dietitian
205-LD
HI
Other
Enumeration date
01/17/2020
Last updated
07/29/2025
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