Provider Demographics
NPI:1235127531
Name:SALDIVAR, VICTOR A (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:A
Last Name:SALDIVAR
Suffix:
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 1:316 FOX HALL LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1806
Mailing Address - Country:US
Mailing Address - Phone:210-342-4398
Mailing Address - Fax:210-704-3180
Practice Address - Street 1:333 N SANTA ROSA AVE
Practice Address - Street 2:PATH DEPT
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3108
Practice Address - Country:US
Practice Address - Phone:210-704-3565
Practice Address - Fax:210-704-3180
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9380207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX12812704Medicaid
TX12812704Medicaid
81P528Medicare ID - Type Unspecified