Provider Demographics
NPI:1710055686
Name:LUGO SALAS, NANCY (MSCCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:LUGO SALAS
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12253 DELACROIX DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-0248
Mailing Address - Country:US
Mailing Address - Phone:915-525-3269
Mailing Address - Fax:915-849-9604
Practice Address - Street 1:12253 DELACROIX DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-0248
Practice Address - Country:US
Practice Address - Phone:915-525-3269
Practice Address - Fax:915-849-9604
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18000235Z00000X
NM3930235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCH32854784OtherEL PASO FIRST CHIP
TXBLUECROSS BLUESHIELDOther528508
TXGH32854784OtherEL PASO FIRST GROUP