Individual
ELIZABETH AVILA SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2911 WALTON RD, TYLER, TX 75701-0733
(903) 266-0409
Mailing address
2911 WALTON RD, TYLER, TX 75701-0733
(903) 266-0409
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
344866
TX
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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