Active NPI
Edward Alexander Porras Dos Santos
- Surgical Assistant
- Katy, TX
National Provider Identifier
1700405248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 20-207
- Practice address
- 21540 Provincial Blvd Apt 2128
Katy, TX 77450-7540 - Phone
- (832) 706-5544
- NPI assigned
- Apr 14, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 20-207 | TX | Primary |
Addresses
Primary practice location
21540 Provincial Blvd Apt 2128
Katy, TX 77450-7540
Mailing address
21540 Provincial Blvd Apt 2128
Katy, TX 77450-7540
Phone (832) 706-5544
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20-207 | TX | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586822400000",
"number": "1700405248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21540 PROVINCIAL BLVD APT 2128",
"city": "KATY",
"state": "TX",
"postal_code": "774507540",
"telephone_number": "832-706-5544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21540 PROVINCIAL BLVD APT 2128",
"city": "KATY",
"state": "TX",
"postal_code": "774507540",
"telephone_number": "832-706-5544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORRAS DOS SANTOS",
"first_name": "EDWARD",
"middle_name": "ALEXANDER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-14",
"last_updated": "2020-04-14",
"certification_date": "2020-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "TX",
"license": "20-207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.