MEDICARE: JESUS ENRIQUE SALCIDO JR. NP

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	363LF0000X	Family Nurse Practitioner	1031301	TX

General Provider Information

NPI Number	:	1255910188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESUS ENRIQUE SALCIDO JR. NP

Provider Business Mailing Address
First Line	:	1508 N ZARAGOZA RD STE A-D
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-8034
Country	:	US
Telephone Number	:	915-298-5425
Fax Number	:

Provider Business Practice Location Address
First Line	:	1508 N ZARAGOZA RD STE A-D
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-8034
Country	:	US
Telephone Number	:	915-298-5425
Fax Number	:

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

Provider Enumeration Date	:	04/07/2021
Last Update Date	:	03/10/2026

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