MEDICARE: HERNAN ALFONSO SALAZAR D.O.

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	E9966	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538220892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HERNAN ALFONSO SALAZAR D.O.

Provider Business Mailing Address
First Line	:	8600 WURZBACH ROAD
Second Line	:	SUITE 1206
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-4334
Country	:	US
Telephone Number	:	210-614-7711
Fax Number	:

Provider Business Practice Location Address
First Line	:	8600 WURZBACH ROAD
Second Line	:	SUITE 1206
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-4334
Country	:	US
Telephone Number	:	210-614-7711
Fax Number	:

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

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	05/03/2016

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