Provider Demographics
NPI:1669653028
Name:SALAS, GRISELDA SANTILLAN (NURSE PRACTIONER)
Entity Type:Individual
Prefix:MRS
First Name:GRISELDA
Middle Name:SANTILLAN
Last Name:SALAS
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Gender:F
Credentials:NURSE PRACTIONER
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Mailing Address - Street 1:6999 MCPHERSON RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6449
Mailing Address - Country:US
Mailing Address - Phone:956-795-4776
Mailing Address - Fax:956-795-0882
Practice Address - Street 1:6999 MCPHERSON RD
Practice Address - Street 2:SUITE 220
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6449
Practice Address - Country:US
Practice Address - Phone:956-795-4776
Practice Address - Fax:956-795-0882
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2016-05-13
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Provider Licenses
StateLicense IDTaxonomies
TXF0607036363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily