Provider Demographics
NPI:1063861342
Name:SALINAS, TEODOSO JR (PTA)
Entity Type:Individual
Prefix:MR
First Name:TEODOSO
Middle Name:
Last Name:SALINAS
Suffix:JR
Gender:M
Credentials:PTA
Other - Prefix:MR
Other - First Name:TEO
Other - Middle Name:
Other - Last Name:SALINAS
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:PO BOX 4742
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78540
Mailing Address - Country:US
Mailing Address - Phone:956-569-1233
Mailing Address - Fax:
Practice Address - Street 1:4118 PEDERNAL ST
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542
Practice Address - Country:US
Practice Address - Phone:956-569-1233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2114817225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant