Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | E 4653 | TX |
NPI | 1033173810 |
---|---|
Provider Name | Abel E Salazar SR. |
First Address | San Antonio, TX 78230-4039 |
Second Address | Austin, TX 78735-8231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 10/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
131371003 | (05) | TX |
C21481 | (02) |