Provider Demographics
NPI:1376393793
Name:SALAS, MICHELLE TORRES (RD, LD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:TORRES
Last Name:SALAS
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8113 CATALPA LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-3806
Mailing Address - Country:US
Mailing Address - Phone:191-552-5354
Mailing Address - Fax:
Practice Address - Street 1:8113 CATALPA LN
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-3806
Practice Address - Country:US
Practice Address - Phone:191-552-5354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT07615133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered