Mohamed-Santa, Odette

Mohamed-Santa, Odette is an individual health care provider with primary practice located at 402 S Bolivar St , Marshall TX 75670-4110. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Mohamed-Santa, Odette can be contacted via phone (903) 935-9100.

Contact Information

Primary practice address
402 S Bolivar St Marshall TX 75670-4110
Fax: (903) 935-9102
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X K3799 Texas

Profile Details

NPI number 1609856632
LBN Legal business name Mohamed-Santa, Odette
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2006
Last updated Oct 15th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609856632 NPPES
Texas Other 8F3586 MEDICARE LEGACY
Texas MEDICAID 104469503 MEDICARE LEGACY

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