MEDICARE: SALERNO RL SALERNO MARTINEZ CD (CBI)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	261Q00000X	Clinic/Center
3	374J00000X	Doula
4	172V00000X	Community Health Worker	TX

General Provider Information

NPI Number	:	1992383855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALERNO RL SALERNO MARTINEZ CD (CBI)

Provider Business Mailing Address
First Line	:	4428 QUAIL HOLLOW RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-6736
Country	:	US
Telephone Number	:	682-227-4379
Fax Number	:

Provider Business Practice Location Address
First Line	:	4428 QUAIL HOLLOW RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-6736
Country	:	US
Telephone Number	:	682-227-4379
Fax Number	:

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

Provider Enumeration Date	:	03/31/2021
Last Update Date	:	01/02/2025

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