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Individual

JACOB CHRISTOPHER SALAZAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
12222 MERIT DR STE 600, DALLAS, TX 75251-3294
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP130060
TX
390200000X
Student in an Organized Health Care Education/Training Program
698408
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
353445501
TX
01
8940UL
BCBS
TX
01
P01598004
RR
Enumeration date
09/30/2015
Last updated
07/19/2022
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