Provider Demographics
NPI:1588955405
Name:SANTILLAN, MELISSA ANNE LAYNO (MD)
Entity type:Individual
Prefix:MRS
First Name:MELISSA ANNE
Middle Name:LAYNO
Last Name:SANTILLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELISSA ANNE
Other - Middle Name:ABESAMIS
Other - Last Name:LAYNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12700 PARK CENTRAL DR
Mailing Address - Street 2:STE 900
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251
Mailing Address - Country:US
Mailing Address - Phone:214-860-6038
Mailing Address - Fax:972-499-1967
Practice Address - Street 1:21214 NORTHWEST FREEWAY
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429
Practice Address - Country:US
Practice Address - Phone:832-912-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ3396207P00000X, 207Q00000X
ALL3477R207Q00000X
ALMD33607207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty