Provider Demographics
NPI:1194201582
Name:SALDIVAR, ABIEL A
Entity Type:Individual
Prefix:
First Name:ABIEL
Middle Name:A
Last Name:SALDIVAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7838 HUEBNER RD APT 8104
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-6130
Mailing Address - Country:US
Mailing Address - Phone:956-489-0096
Mailing Address - Fax:
Practice Address - Street 1:1530 AUSTIN HWY STE 112
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-6057
Practice Address - Country:US
Practice Address - Phone:210-824-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX343911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice