Provider Demographics
NPI:1457009482
Name:LOPEZ-SALAZAR, YELITZA MERCEDES (MT)
Entity Type:Individual
Prefix:
First Name:YELITZA
Middle Name:MERCEDES
Last Name:LOPEZ-SALAZAR
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 SNAKE RIVER RD STE D
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-7746
Mailing Address - Country:US
Mailing Address - Phone:346-546-9653
Mailing Address - Fax:832-626-3627
Practice Address - Street 1:11511 KATY FWY STE 406
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1903
Practice Address - Country:US
Practice Address - Phone:863-812-6228
Practice Address - Fax:832-626-3627
Is Sole Proprietor?:No
Enumeration Date:2022-03-18
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT126765225700000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist