Provider Demographics
NPI:1972868842
Name:SALAZAR, SERGIO (OTR)
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14914 HONEY LN
Mailing Address - Street 2:A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77085-4063
Mailing Address - Country:US
Mailing Address - Phone:833-766-1295
Mailing Address - Fax:
Practice Address - Street 1:14914 HONEY LN
Practice Address - Street 2:A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77085-4063
Practice Address - Country:US
Practice Address - Phone:833-766-1295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113580225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics