Provider Demographics
NPI:1023613262
Name:SALDIVAR, LISA (FNP-C)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:SALDIVAR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7616 CULEBRA RD STE 130
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-1476
Mailing Address - Country:US
Mailing Address - Phone:726-201-3660
Mailing Address - Fax:726-262-0101
Practice Address - Street 1:7616 CULEBRA RD STE 130
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-1476
Practice Address - Country:US
Practice Address - Phone:726-201-3660
Practice Address - Fax:726-262-0101
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1020168363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily