Basic Information
| Provider Information | |||||||||
| NPI: | 1750955688 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SALDIVAR | ||||||||
| FirstName: | ISAAC | ||||||||
| MiddleName: | MARTINEZ | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8441 HIGHWAY 47, CLINICAL BUILDING 1, SUITE 1100 | ||||||||
| Address2: | |||||||||
| City: | BRYAN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9794360700 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8441 HIGHWAY 47, CLINICAL BUILDING 1, SUITE 1100 | ||||||||
| Address2: | |||||||||
| City: | BRYAN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 778077780 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9794360700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2021 | ||||||||
| LastUpdateDate: | 05/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | TX | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.