Provider Demographics
NPI:1033173810
Name:SALAZAR, ABEL E SR (MD)
Entity Type:Individual
Prefix:
First Name:ABEL
Middle Name:E
Last Name:SALAZAR
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9531 SINSONTE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4039
Mailing Address - Country:US
Mailing Address - Phone:210-464-3989
Mailing Address - Fax:210-348-9411
Practice Address - Street 1:7610 W HWY 71
Practice Address - Street 2:F
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8231
Practice Address - Country:US
Practice Address - Phone:512-288-0859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE 4653208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131371003Medicaid
TX131371003Medicaid
TX80041RMedicare ID - Type Unspecified