Provider Demographics
NPI:1942535828
Name:ARELLANO, SALVADOR JR (PA)
Entity Type:Individual
Prefix:
First Name:SALVADOR
Middle Name:
Last Name:ARELLANO
Suffix:JR
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3106 E INGLE RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-1402
Mailing Address - Country:US
Mailing Address - Phone:956-262-9661
Mailing Address - Fax:956-262-9664
Practice Address - Street 1:222 E RIDGE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1251
Practice Address - Country:US
Practice Address - Phone:956-627-2483
Practice Address - Fax:956-627-2677
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02040363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX889N43OtherBCBS
TXTXB165715Medicare PIN