Provider Demographics
NPI:1407610249
Name:SALAS, SARAH ISABEL (RD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ISABEL
Last Name:SALAS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13430 WAKEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-4974
Mailing Address - Country:US
Mailing Address - Phone:210-777-4810
Mailing Address - Fax:
Practice Address - Street 1:13430 WAKEWOOD ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233-4974
Practice Address - Country:US
Practice Address - Phone:210-777-4810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT89271133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered