Organization
MARIO R. SALAZAR, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO REY SALAZAR M.D. (OWNER)
(972) 296-4458
Entity
Organization
Contact information
Practice address
7979 W VIRGINIA DR, DALLAS, TX 75237-3798
(972) 296-4458
(972) 875-5121
Mailing address
PO BOX 301, ENNIS, TX 75120-0301
(972) 296-4458
(972) 875-5121
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M7587
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0012QC
BCBS
TX
Enumeration date
07/12/2007
Last updated
08/02/2012
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