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Individual

ANGELICA MARIA SALAZAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
101 CROWN POINTE BLVD STE 200, WILLOW PARK, TX 76087-1293
(817) 599-7661
Mailing address
101 CROWN POINTE BLVD STE 200, WILLOW PARK, TX 76087-1293

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA06763
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
319649501
TX
01
8N0424
BCBSTX
TX
Enumeration date
08/19/2010
Last updated
01/11/2021
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