Provider Demographics
NPI:1598740359
Name:DELOS SANTOS, ALAN JOHN SOTO (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN JOHN
Middle Name:SOTO
Last Name:DELOS SANTOS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 W INTERSTATE 10 FL 7800I103
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4700
Mailing Address - Country:US
Mailing Address - Phone:844-863-3236
Mailing Address - Fax:
Practice Address - Street 1:7800 W INTERSTATE 10 FL 7800I103
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4700
Practice Address - Country:US
Practice Address - Phone:844-863-3236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417205207R00000X
MI4301075537207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301075537OtherSTATE BOARD LICENSE NO.
PAMD417205OtherSTATE BOARD LICENSE NO.