Provider Demographics
NPI:1508497629
Name:SALMON, AMBER GAYLE
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:GAYLE
Last Name:SALMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5213 MEADOW FLD APT 4
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-4530
Mailing Address - Country:US
Mailing Address - Phone:224-733-4880
Mailing Address - Fax:
Practice Address - Street 1:5213 MEADOW FLD APT 4
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-4530
Practice Address - Country:US
Practice Address - Phone:224-733-4880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant