Provider Demographics
NPI:1891443883
Name:HAMER, MONICA SALAZAR (CST-T, LMT, MTI)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:SALAZAR
Last Name:HAMER
Suffix:
Gender:F
Credentials:CST-T, LMT, MTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7193 W CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-1943
Mailing Address - Country:US
Mailing Address - Phone:214-642-0242
Mailing Address - Fax:
Practice Address - Street 1:5930 LBJ FWY STE 380
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6370
Practice Address - Country:US
Practice Address - Phone:214-546-8996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT035964225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXMT035964OtherTEXAS DEPARTMENT OF LICENSING AND REGULATION