Provider Demographics
NPI:1790790186
Name:JOSE SALGUERO, MD, PA
Entity Type:Organization
Organization Name:JOSE SALGUERO, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:JE
Authorized Official - Last Name:SALGUERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-875-1010
Mailing Address - Street 1:900 W ENNIS AVE
Mailing Address - Street 2:SUITE 119
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-3736
Mailing Address - Country:US
Mailing Address - Phone:972-875-1010
Mailing Address - Fax:
Practice Address - Street 1:900 W ENNIS AVE
Practice Address - Street 2:SUITE 119
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-3736
Practice Address - Country:US
Practice Address - Phone:972-875-1010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty