Provider Demographics
NPI:1518070788
Name:SALAZAR, EDUARDO (LPC)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12902 HAYNES RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77066-1119
Mailing Address - Country:US
Mailing Address - Phone:832-484-1088
Mailing Address - Fax:281-240-6481
Practice Address - Street 1:12902 HAYNES RD
Practice Address - Street 2:SUITE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77066-1119
Practice Address - Country:US
Practice Address - Phone:832-484-1088
Practice Address - Fax:281-240-6481
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17783101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0029KXOtherBC/BS