Healthcare Provider Details

I. General information

NPI: 1578260238
Provider Name (Legal Business Name): MONICA RAE SALAZAR PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8017 MESA DR
AUSTIN TX
78731-1300
US

IV. Provider business mailing address

9529 HUNTER LN
AUSTIN TX
78748-3723
US

V. Phone/Fax

Practice location:
  • Phone: 512-791-3702
  • Fax:
Mailing address:
  • Phone: 425-985-2451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1373350
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: