MEDICARE: SALMON MEDICAL PARTNERS, PA

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	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1710594882
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALMON MEDICAL PARTNERS, PA

Provider Business Mailing Address
First Line	:	PO BOX 294806
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78029-4806
Country	:	US
Telephone Number	:	830-896-8080
Fax Number	:	830-866-8080

Provider Business Practice Location Address
First Line	:	7213 RED HAWK CT
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4106
Country	:	US
Telephone Number	:	830-896-8080
Fax Number	:	830-896-8080

Authorized Official
Title or Position	:	MD/OWNER
Name	:	THOMAS HARALD SALMON
Credential	:	MD
Telephone Number	:	830-896-8080

Provider Enumeration Date	:	09/23/2020
Last Update Date	:	09/23/2020

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