Provider Demographics
NPI:1104089630
Name:SALMASI, SKYLER MARIE (NP-C)
Entity type:Individual
Prefix:DR
First Name:SKYLER
Middle Name:MARIE
Last Name:SALMASI
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 FM 1764 RD
Mailing Address - Street 2:STE 190
Mailing Address - City:LA MARQUE
Mailing Address - State:TX
Mailing Address - Zip Code:77568-2826
Mailing Address - Country:US
Mailing Address - Phone:281-886-8964
Mailing Address - Fax:409-440-8071
Practice Address - Street 1:2600 FM 1764 RD
Practice Address - Street 2:SUITE 190
Practice Address - City:LA MARQUE
Practice Address - State:TX
Practice Address - Zip Code:77568-2824
Practice Address - Country:US
Practice Address - Phone:281-886-8964
Practice Address - Fax:409-440-8071
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX666806363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00220ZOtherMEDICARE GROUP PTAN
TX00220ZOtherMEDICARE GROUP PTAN