MEDICARE: LEORA SALO DESIGNS, INC

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	225X00000X	Occupational Therapist	105856	TX

General Provider Information

NPI Number	:	1275081044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEORA SALO DESIGNS, INC

Provider Business Mailing Address
First Line	:	PO BOX 541221
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77254-1221
Country	:	US
Telephone Number	:	713-557-5589
Fax Number	:

Provider Business Practice Location Address
First Line	:	5959 W. LOOP SOUTH
Second Line	:	SUITE 206
City	:	HOUSTON
State	:	TX
Zip	:	77254
Country	:	US
Telephone Number	:	713-557-5589
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LEORA H SALO
Credential	:	OTR
Telephone Number	:	713-557-5589

Provider Enumeration Date	:	09/21/2016
Last Update Date	:	09/21/2016

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