1033173810 NPI number — ABEL E SALAZAR SR. MD

Table of content: ABEL E SALAZAR SR. MD (NPI 1033173810)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033173810 NPI number — ABEL E SALAZAR SR. MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALAZAR
Provider First Name:
ABEL
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
SR.
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1033173810
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/10/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9531 SINSONTE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78230-4039
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-464-3989
Provider Business Mailing Address Fax Number:
210-348-9411

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7610 W HWY 71
Provider Second Line Business Practice Location Address:
F
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78735-8231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-288-0859
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/17/2006

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: 208D00000X , with the licence number:  E 4653 , 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: 131371003 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".