MEDICARE: MARK SALVADOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	10688A	AZ
2	225200000X	Physical Therapy Assistant	2185782	TX

General Provider Information

NPI Number	:	1093139545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK SALVADOR

Provider Business Mailing Address
First Line	:	6150 OAKMONT TRL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-2841
Country	:	US
Telephone Number	:	408-821-9929
Fax Number	:	224-661-6570

Provider Business Practice Location Address
First Line	:	6150 OAKMONT TRL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-2841
Country	:	US
Telephone Number	:	408-821-9929
Fax Number	:	224-661-6570

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2014
Last Update Date	:	04/01/2026

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Directions to “ MARK SALVADOR ” Practice Location

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