Basic Information
Provider Information
NPI: 1760773295
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SALINAS
FirstName: GABRIEL
MiddleName: JESUS
NamePrefix:  
NameSuffix: JR.
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3705 MEDICAL PKWY STE 250
Address2:  
City: AUSTIN
State: TX
PostalCode: 787051022
CountryCode: US
TelephoneNumber: 5123021210
FaxNumber: 5124519752
Practice Location
Address1: 3705 MEDICAL PKWY STE 250
Address2:  
City: AUSTIN
State: TX
PostalCode: 787051022
CountryCode: US
TelephoneNumber: 5123021210
FaxNumber: 5124519752
Other Information
ProviderEnumerationDate: 05/02/2011
LastUpdateDate: 02/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XQ8344TXY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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