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General NPI Number Information
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NPI Number | 1316549488
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Entity Type | Individual
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Provider Name | SALVADOR EDWARD ENRIQUEZ
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Gender | Male
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Dates
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Enumeration Date | 11/12/2020
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 3701 N MAIN ST
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City | TAYLOR
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State | TX
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Zip | 76574-4975
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Country | US
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Telephone | 512-353-6333
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Fax |
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Provider Business Mailing Address
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Address Line | 12308 TERRAZA CIR
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City | AUSTIN
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State | TX
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Zip | 78726-2365
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Country | US
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Telephone | 512-217-4989
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 30225
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License Number State | TX
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