Provider Demographics
NPI:1952078255
Name:SALAS, JOANA MALLARI (APRN)
Entity Type:Individual
Prefix:
First Name:JOANA
Middle Name:MALLARI
Last Name:SALAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10513 CEDAR BREAKS VW
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-8989
Mailing Address - Country:US
Mailing Address - Phone:662-422-2927
Mailing Address - Fax:
Practice Address - Street 1:4500 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1650
Practice Address - Country:US
Practice Address - Phone:662-422-2927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1049955363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health