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NPI Code Detail

MEDICARE: ANGELINA SALAS MA, BCBA, LBA

MEDICARE: ANGELINA SALAS MA, BCBA, LBA
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
1103K00000XBehavior Analyst5767TX

General Provider Information

NPI Number : 1740800622
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELINA SALAS MA, BCBA, LBA
Provider Business Mailing Address
First Line : 2401 MUSTANG DR
Second Line :
City : GRAPEVINE
State : TX
Zip : 76051-8640
Country : US
Telephone Number : 817-722-6118
Fax Number :
Provider Business Practice Location Address
First Line : 4140 MOLER ST
Second Line :
City : DALLAS
State : TX
Zip : 75211-6288
Country : US
Telephone Number : 214-336-6780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2020
Last Update Date : 12/08/2025

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