Provider Demographics
NPI:1629304811
Name:SALVO, ERIKA ALFARO (PA-C)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:ALFARO
Last Name:SALVO
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:WINOOSKI
Mailing Address - State:VT
Mailing Address - Zip Code:05404-0005
Mailing Address - Country:US
Mailing Address - Phone:802-857-0400
Mailing Address - Fax:833-316-1780
Practice Address - Street 1:2201 FM 715
Practice Address - Street 2:ENDEAVOR FAMILY CLINIC
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79706-4211
Practice Address - Country:US
Practice Address - Phone:802-857-0400
Practice Address - Fax:833-848-4175
Is Sole Proprietor?:No
Enumeration Date:2009-10-23
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06450207Q00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L21361Medicare PIN