Provider Demographics
NPI:1144403387
Name:GUAJARDO SALINAS, GUSTAVO E (MD)
Entity Type:Individual
Prefix:DR
First Name:GUSTAVO
Middle Name:E
Last Name:GUAJARDO SALINAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:18707 HARDY OAK BLVD STE 320
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4890
Practice Address - Country:US
Practice Address - Phone:210-614-0880
Practice Address - Fax:210-692-0258
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0392208G00000X
ARE-8210208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX375784102Medicaid
ARE-8210OtherMED. LICENSE