Provider Demographics
NPI:1629458807
Name:SALAS, MARIA II
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:SALAS
Suffix:II
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 1:10425 MACKINAW ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79924-2408
Mailing Address - Country:US
Mailing Address - Phone:915-730-2282
Mailing Address - Fax:
Practice Address - Street 1:10425 MACKINAW ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-2408
Practice Address - Country:US
Practice Address - Phone:915-730-2282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency