Provider Demographics
NPI:1972695906
Name:SALTER, DIANA TUYET LINH (LAT)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:TUYET LINH
Last Name:SALTER
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:TUYET LINH
Other - Last Name:OPERHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAT
Mailing Address - Street 1:302 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-1032
Mailing Address - Country:US
Mailing Address - Phone:512-509-0287
Mailing Address - Fax:512-509-7606
Practice Address - Street 1:200 MEDICAL PKWY STE 130
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78738-1790
Practice Address - Country:US
Practice Address - Phone:512-346-4933
Practice Address - Fax:512-346-4934
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT15102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer