1063685378 NPI number — JEANMARIE K SALINAS, M.D.,P.A.

Table of content: (NPI 1063685378)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063685378 NPI number — JEANMARIE K SALINAS, M.D.,P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JEANMARIE K SALINAS, M.D.,P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1063685378
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2084
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRIENDSWOOD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77549-2084
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-481-4058
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11914 ASTORIA BLVD
Provider Second Line Business Practice Location Address:
SUITE 260
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77089-6064
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-481-4058
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/08/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SALINAS
Authorized Official First Name:
JEANMARIE
Authorized Official Middle Name:
K
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
281-481-4058

Provider Taxonomy Codes

  • Taxonomy code: 207VG0400X , with the licence number:  H4668 , 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: 00Z552 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 114686201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4113936 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: E12523 . This is a "UPIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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