Provider Demographics
NPI:1427683804
Name:SALAIS, LORENZO JR (LVN)
Entity type:Individual
Prefix:
First Name:LORENZO
Middle Name:
Last Name:SALAIS
Suffix:JR
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3628 MCCONNELL AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79904-6018
Mailing Address - Country:US
Mailing Address - Phone:915-253-1393
Mailing Address - Fax:
Practice Address - Street 1:3628 MCCONNELL AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79904-6018
Practice Address - Country:US
Practice Address - Phone:915-253-1393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225590164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse