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NPI Code Detail

MEDICARE: ENRIQUE SALDIVAR LCSW

MEDICARE:   ENRIQUE  SALDIVAR  LCSW
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
11041C0700XClinical Social Worker32064TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20007HCOTHERTXBLUE CROSS BLUE SHIELD
37759307OTHERTXAETNA BEHAV. HEALTH

General Provider Information

NPI Number : 1639271067
Entity Type Code : Individual
Provider Name (Legal Business Name) : ENRIQUE SALDIVAR LCSW
Provider Business Mailing Address
First Line : 601 UNIVERSITY DR
Second Line : SUITE #105
City : FORT WORTH
State : TX
Zip : 76107-2168
Country : US
Telephone Number : 817-360-2983
Fax Number : 817-386-5880
Provider Business Practice Location Address
First Line : 601 UNIVERSITY DR
Second Line : SUITE #105
City : FORT WORTH
State : TX
Zip : 76107-2168
Country : US
Telephone Number : 817-360-2983
Fax Number : 817-386-5880
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2006
Last Update Date : 02/20/2009

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Directions to “ ENRIQUE SALDIVAR LCSW” Practice Location

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