Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1059107 | TX |
NPI | 1023775947 |
---|---|
Provider Name | David Salazar |
First Address | Forney, TX 75126-7024 |
Second Address | Forney, TX 75126-7024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2021 |
Last Update Date | 27/11/2021 |