Basic Information
| Provider Information | |||||||||
| NPI: | 1295866861 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SALDIVAR | ||||||||
| FirstName: | PATRICIA | ||||||||
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| Credential: | AUDIOLOGIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8800 SE SUNNYSIDE RD | ||||||||
| Address2: | STE 300N | ||||||||
| City: | CLACKAMAS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970155703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5128580300 | ||||||||
| FaxNumber: | 5128582714 | ||||||||
| Practice Location | |||||||||
| Address1: | 2100 FM 802 | ||||||||
| Address2: | SUITE 2030 | ||||||||
| City: | BROWNSVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785262864 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9565442783 | ||||||||
| FaxNumber: | 9565445160 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2007 | ||||||||
| LastUpdateDate: | 11/08/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 50982 | TX | N | Speech, Language and Hearing Service Providers | Audiologist | 237700000X | 50982 | TX | N | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | 237600000X | TX | Y | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 231H00000X | TX | N | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | 022457801 | 05 | TX | MEDICAID |