Provider Demographics
NPI:1972322899
Name:SANTOS, ALVIN B (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ALVIN
Middle Name:B
Last Name:SANTOS
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9802 CHASEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-8753
Mailing Address - Country:US
Mailing Address - Phone:972-835-8404
Mailing Address - Fax:
Practice Address - Street 1:9802 CHASEFIELD DR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-8753
Practice Address - Country:US
Practice Address - Phone:972-835-8404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1177362363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health