MEDICARE: SELINDA SALINAS GUTIERREZ RN

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	163WP2201X	Ambulatory Care Registered Nurse	626926	TX

General Provider Information

NPI Number	:	1205938339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SELINDA SALINAS GUTIERREZ RN

Provider Business Mailing Address
First Line	:	1629 TREASURE HILLS BLVD
Second Line	:	SUITE B -5
City	:	HARLINGEN
State	:	TX
Zip	:	78550-8907
Country	:	US
Telephone Number	:	956-366-4502
Fax Number	:	956-366-4501

Provider Business Practice Location Address
First Line	:	1629 TREASURE HILLS BLVD
Second Line	:	SUITE B-5
City	:	HARLINGEN
State	:	TX
Zip	:	78550-8907
Country	:	US
Telephone Number	:	956-366-4502
Fax Number	:	956-366-4501

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

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	07/08/2007

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