Most Relevant Information
Provider Data
| NPI Number: | 1003467762 |
| Provider Name: | IVY SANTANA |
| Entity Type: | Individual |
| Taxonomy Code: | 3747A0650X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/24/2019 |
| Last Updated: | 09/24/2019 |
Provider Practice Location
5600 SPIRITUS PL
EL PASO
TX
799321924
Practice Location Phone/Fax
| Phone: | 6197560470 |
| Fax: |
Provider Mailing Location
5600 SPIRITUS PL
EL PASO
TX
799321924
Provider Mailing Phone/Fax
| Phone: | 6197560470 |
| Fax: |