MEDICARE: DR. KIMBERLY COLLEEN SALAZAR M.D.

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	207R00000X	Internal Medicine Physician	L8756	TX
2	207K00000X	Allergy & Immunology Physician	L8756	TX

General Provider Information

NPI Number	:	1528041290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY COLLEEN SALAZAR M.D.

Provider Business Mailing Address
First Line	:	3551 ROGER BROOKE DR
Second Line	:
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234-4504
Country	:	US
Telephone Number	:	210-916-3011
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 COCHRANE CIR BLDG 7505
Second Line	:
City	:	FORT CARSON
State	:	CO
Zip	:	80913-4613
Country	:	US
Telephone Number	:	719-526-7129
Fax Number	:

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

Provider Enumeration Date	:	11/27/2005
Last Update Date	:	09/20/2022

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