Provider Demographics
NPI:1659542157
Name:SALVATO, JUDITH W
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:W
Last Name:SALVATO
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 1:2406 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1432
Mailing Address - Country:US
Mailing Address - Phone:713-524-5354
Mailing Address - Fax:713-524-7129
Practice Address - Street 1:2406 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-1432
Practice Address - Country:US
Practice Address - Phone:713-524-5354
Practice Address - Fax:713-524-7129
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7600217552156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician