Provider Demographics
NPI:1588812671
Name:SALAMANCA, ANTONIA (OTR)
Entity Type:Individual
Prefix:
First Name:ANTONIA
Middle Name:
Last Name:SALAMANCA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 W SCHUNIOR ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-2233
Mailing Address - Country:US
Mailing Address - Phone:956-984-6131
Mailing Address - Fax:956-984-7648
Practice Address - Street 1:1900 W SCHUNIOR ST
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-2234
Practice Address - Country:US
Practice Address - Phone:956-984-6131
Practice Address - Fax:956-984-7648
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX345472355S0801X
TX114969225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3371114-03Medicaid