Healthcare Provider Details

I. General information

NPI: 1255742425
Provider Name (Legal Business Name): OLAYA SALINAS PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2014
Last Update Date: 05/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 EXECUTIVE CENTER DR SUITE 128
AUSTIN TX
78731-1642
US

IV. Provider business mailing address

3520 EXECUTIVE CENTER DR SUITE 128
AUSTIN TX
78731-1642
US

V. Phone/Fax

Practice location:
  • Phone: 512-343-0222
  • Fax: 210-692-0223
Mailing address:
  • Phone: 512-343-0222
  • Fax: 210-692-0223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2046050
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: