Provider Demographics
NPI:1295750008
Name:CRUZ-FLORES, SALVADOR (MD)
Entity type:Individual
Prefix:
First Name:SALVADOR
Middle Name:
Last Name:CRUZ-FLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 ALBERTA AVE STE 101
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2709
Mailing Address - Country:US
Mailing Address - Phone:915-215-4480
Mailing Address - Fax:915-545-5755
Practice Address - Street 1:4615 ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2702
Practice Address - Country:US
Practice Address - Phone:915-545-6830
Practice Address - Fax:915-545-6705
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1002112084N0400X
TXP84592084A2900X
TX442112084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX284407YRRZMedicare UPIN