Healthcare Provider Details

I. General information

NPI: 1740417872
Provider Name (Legal Business Name): CRYSTAL MICHELLE SALINAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2009
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 FM 685 STE 600
PFLUGERVILLE TX
78660-7095
US

IV. Provider business mailing address

6034 W COURTYARD DR STE 110
AUSTIN TX
78730-5064
US

V. Phone/Fax

Practice location:
  • Phone: 512-808-0190
  • Fax:
Mailing address:
  • Phone: 512-328-2266
  • Fax: 512-328-2055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP3576
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: