Provider Demographics
NPI:1720483761
Name:SALAZAR CONTRERAS, ANA
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:SALAZAR CONTRERAS
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 1:6106 RISING MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-5359
Mailing Address - Country:US
Mailing Address - Phone:469-877-1033
Mailing Address - Fax:
Practice Address - Street 1:1001 COLLEGE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3000
Practice Address - Country:US
Practice Address - Phone:469-877-1033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2016-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126491363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily