Provider Demographics
NPI:1043824436
Name:SALVADOR INTEGRATIVE WELLNESS, INC.
Entity Type:Organization
Organization Name:SALVADOR INTEGRATIVE WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:SARRA
Authorized Official - Last Name:SALVADOR
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:214-699-9146
Mailing Address - Street 1:3839 MCKINNEY AVE STE 155
Mailing Address - Street 2:#2354
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-1488
Mailing Address - Country:US
Mailing Address - Phone:214-699-9146
Mailing Address - Fax:
Practice Address - Street 1:5148 VILLAGE CREEK DR STE 300
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5064
Practice Address - Country:US
Practice Address - Phone:469-661-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-02
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care