Provider Demographics
NPI:1942012828
Name:SAULTERS, LATRICE (LVN)
Entity type:Individual
Prefix:
First Name:LATRICE
Middle Name:
Last Name:SAULTERS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 APPLE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75134-2011
Mailing Address - Country:US
Mailing Address - Phone:214-780-7439
Mailing Address - Fax:
Practice Address - Street 1:2929 MARTIN LUTHER KING JR BLVD STE 4
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75215-2322
Practice Address - Country:US
Practice Address - Phone:214-421-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX303981164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse