Provider Demographics
NPI:1306462023
Name:ROSADO, SANTA A (DC)
Entity type:Individual
Prefix:
First Name:SANTA
Middle Name:A
Last Name:ROSADO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SANTA
Other - Middle Name:A
Other - Last Name:ROSADO ACEVEDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5577 CYPRESS WILLOW BND
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76126-2635
Mailing Address - Country:US
Mailing Address - Phone:817-739-4682
Mailing Address - Fax:
Practice Address - Street 1:912 W RANDOL MILL RD STE A
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2564
Practice Address - Country:US
Practice Address - Phone:682-367-2219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14389111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner