Simon C Santillanes, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2166665 Issued in TX

Practice address

930 W Centerville Rd Ste 930
Garland, TX 75041-5823

Phone

(972) 303-7021

NPI assigned

Nov 16, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1639835309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 SPRING VALLEY RD STE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752542512",
            "telephone_number": "214-466-1340",
            "fax_number": "214-466-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 W CENTERVILLE RD STE 930",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750415823",
            "telephone_number": "972-303-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTILLANES",
        "first_name": "SIMON",
        "middle_name": "C",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-16",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2166665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Lynn Sanderson, MS
• Sandra V. Moore Mdpa
• Sanjeck Health Care Services
• Gilberta Santana, APRN
• Godfrey Santillana, LPC
• Katelyn Blair Sapundjieff, COTA
• Nana-Sarpong Kwadwo Sarpong
• Rowdy Dwight Sarrett, PA-C
• Sas Healthcare Inc
• Satellite Professional Healthcare Serv Inc

• Physical Therapy Assistant in Garland, TX
• Providers in Garland, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.