Provider Demographics
NPI:1417579236
Name:SALGADO, ANDRES
Entity Type:Individual
Prefix:MR
First Name:ANDRES
Middle Name:
Last Name:SALGADO
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 1:3712 IDALIA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79930-5420
Mailing Address - Country:US
Mailing Address - Phone:915-433-2588
Mailing Address - Fax:
Practice Address - Street 1:3712 IDALIA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79930-5420
Practice Address - Country:US
Practice Address - Phone:915-433-2588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant