MEDICARE: ASHLEY DOMINIQUE SALAZAR

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	363LA2100X	Acute Care Nurse Practitioner	1210832	TX
2	163W00000X	Registered Nurse	935154	TX

General Provider Information

NPI Number	:	1114861143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY DOMINIQUE SALAZAR

Provider Business Mailing Address
First Line	:	518 LONGSPUR CT
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78045-8949
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	518 LONGSPUR CT
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78045-8949
Country	:	US
Telephone Number	:	956-649-4240
Fax Number	:

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

Provider Enumeration Date	:	04/18/2026
Last Update Date	:	04/20/2026

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Directions to “ ASHLEY DOMINIQUE SALAZAR ” Practice Location

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