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General NPI Number Information
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NPI Number | 1679517429
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Entity Type | Organization
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Legal Business Name | LIVE OAK CARDIOLOGY, PA
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 02/14/2024
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Provider Practice Location Address
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Address Line | 112 RAILROAD ST.
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City | BUDA
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State | TX
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Zip | 78610
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Country | US
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Telephone | 512-295-2558
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Fax | 512-295-2282
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Provider Business Mailing Address
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Address Line | 112 RAILROAD ST.
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City | BUDA
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State | TX
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Zip | 78610
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Country | US
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Telephone | 512-295-2558
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Fax | 512-295-2282
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Authorized Official
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Title or Position | OWNER
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Name | DR. DOUGLAS RUSSEL SALMON
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Credential | MD
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Telephone | 512-295-2558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | F7128
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License Number State | TX
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