1053618082 NPI number — ELIZABETH ANN SALINAS P.A.

Table of content: ELIZABETH ANN SALINAS P.A. (NPI 1053618082)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053618082 NPI number — ELIZABETH ANN SALINAS P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALINAS
Provider First Name:
ELIZABETH
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
P.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053618082
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6139
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78502-6139
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-362-2171
Provider Business Mailing Address Fax Number:
956-378-9376

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5520 LEONARDO DA VINCI STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDINBURG
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78539-1422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-362-3636
Provider Business Practice Location Address Fax Number:
956-362-2699
Provider Enumeration Date:
02/28/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  PA07118 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 327606502 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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