MEDICARE: DR. CARLOS E. SALAZAR M.D.

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	207Q00000X	Family Medicine Physician	G7716	TX
2	208D00000X	General Practice Physician	G7716	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306955653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLOS E. SALAZAR M.D.

Provider Business Mailing Address
First Line	:	310 W OAKLAWN RD
Second Line	:
City	:	PLEASANTON
State	:	TX
Zip	:	78064-4033
Country	:	US
Telephone Number	:	830-569-8940
Fax Number	:	830-569-8320

Provider Business Practice Location Address
First Line	:	302 N BUTLER ST
Second Line	:
City	:	KARNES CITY
State	:	TX
Zip	:	78118-2180
Country	:	US
Telephone Number	:	830-780-3100
Fax Number	:	830-780-3130

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	03/02/2015

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