MEDICARE: MR. DAVID ALLEN SALINAS EMT-I

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	146M00000X	Intermediate Emergency Medical Technician	145533	TX

General Provider Information

NPI Number	:	1023338746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID ALLEN SALINAS EMT-I

Provider Business Mailing Address
First Line	:	1109 JOSEPHINE DR
Second Line	:
City	:	ALICE
State	:	TX
Zip	:	78332-3831
Country	:	US
Telephone Number	:	361-562-8064
Fax Number	:

Provider Business Practice Location Address
First Line	:	1107 SANTA ROSA ST
Second Line	:
City	:	SAN DIEGO
State	:	TX
Zip	:	78384-3917
Country	:	US
Telephone Number	:	361-562-8064
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2010
Last Update Date	:	06/03/2010

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