Provider Demographics
NPI:1811302144
Name:SALAZAR, LAUREN ANNE (OD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ANNE
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-3853
Mailing Address - Country:US
Mailing Address - Phone:806-655-7748
Mailing Address - Fax:806-655-2871
Practice Address - Street 1:1801 4TH AVE
Practice Address - Street 2:
Practice Address - City:CANYON
Practice Address - State:TX
Practice Address - Zip Code:79015-3853
Practice Address - Country:US
Practice Address - Phone:806-655-7748
Practice Address - Fax:806-655-2871
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8440TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist