Provider Demographics
NPI:1811604929
Name:SALAKO, REINAL R
Entity type:Individual
Prefix:
First Name:REINAL
Middle Name:R
Last Name:SALAKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8515 HEARTH DR APT 21
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2630
Mailing Address - Country:US
Mailing Address - Phone:281-883-3615
Mailing Address - Fax:
Practice Address - Street 1:8515 HEARTH DR APT 21
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2630
Practice Address - Country:US
Practice Address - Phone:281-883-3615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX021964251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health