Provider Demographics
NPI:1558089268
Name:SALOMON, BRYAN REY (LVN)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:REY
Last Name:SALOMON
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 MERIDA ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-7685
Mailing Address - Country:US
Mailing Address - Phone:210-942-1703
Mailing Address - Fax:
Practice Address - Street 1:603 MERIDA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-7685
Practice Address - Country:US
Practice Address - Phone:210-942-1703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX333471164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse