| Organization Name: | SUSIE NELY SANT'ANNA |
| NPI Number: | 1811170186 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSIE N SANTANNA (OWNER) |
| Mailing Address: | 12400 St Hwy 71 W Ste 350-128 Bee Cave |
| State: | TX US |
| Postal Code: | 787386517 |
| Phone Number: | 5127194545 |
| Fax Number: | 5123723396 |
| NPI Enumeration Date: | 12/10/2007 |
| NPI Last Update Date: | 06/02/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 1258 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |