Individual
DR. MARISSA SALAZAR CANTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-2078
(210) 358-1972
Mailing address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-2078
(210) 358-1972
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2015015074
MO
2080C0008X
Child Abuse Pediatrics Physician
S6584
TX
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
S6584
TX
208M00000X
Hospitalist Physician
2015015074
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
412395201
—
TX
01
—
412395202
CSHCN
TX
Enumeration date
03/22/2012
Last updated
02/17/2022
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