MEDICARE: JUDITH W SALVATO

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	156FX1800X	Optician	7600217552	TX

General Provider Information

NPI Number	:	1659542157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH W SALVATO

Provider Business Mailing Address
First Line	:	2406 SUNSET BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-1432
Country	:	US
Telephone Number	:	713-524-5354
Fax Number	:	713-524-7129

Provider Business Practice Location Address
First Line	:	2406 SUNSET BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-1432
Country	:	US
Telephone Number	:	713-524-5354
Fax Number	:	713-524-7129

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

Provider Enumeration Date	:	03/12/2008
Last Update Date	:	03/12/2008

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Directions to “ JUDITH W SALVATO ” Practice Location

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