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General NPI Number Information
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NPI Number | 1972733236
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Entity Type | Individual
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Provider Name | LORELEI LYNN SALAZAR P.A.-C.
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Gender | Female
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Dates
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Enumeration Date | 07/21/2009
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 6915 WEST AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78213-1822
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Country | US
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Telephone | 210-341-1487
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Fax |
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Provider Business Mailing Address
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Address Line | 2802 ZURICH
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City | SAN ANTONIO
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State | TX
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Zip | 78230-2882
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Country | US
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Telephone | 210-573-2725
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00036
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License Number State | TX
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