Provider Demographics
NPI:1306955653
Name:SALAZAR, CARLOS E (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:E
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 W OAKLAWN RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78064-4033
Mailing Address - Country:US
Mailing Address - Phone:830-569-8940
Mailing Address - Fax:830-569-8320
Practice Address - Street 1:302 N BUTLER ST
Practice Address - Street 2:
Practice Address - City:KARNES CITY
Practice Address - State:TX
Practice Address - Zip Code:78118-2180
Practice Address - Country:US
Practice Address - Phone:830-780-3100
Practice Address - Fax:830-780-3130
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7716207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133361908Medicaid
TX133361908Medicaid
TX8L2462Medicare PIN