Individual provider Active NPI

David Russell Salazar, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1205636370
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1192980 Issued in TX
Practice address
10300 Heritage St Ste 250
San Antonio, TX 78216-3962
Phone
(210) 375-4911
Fax
(210) 855-5189
NPI assigned
Mar 17, 2025
Last updated
Jul 15, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 1192980 TX Primary

Addresses

Primary practice location

10300 Heritage St Ste 250
San Antonio, TX 78216-3962

Mailing address

29629 Elkhorn RDG
Boerne, TX 78015-5104
Phone (210) 793-3120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250612001088 TX Practitioner - Nurse Practitioner 8820273170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors on the Go PLLCGroup PAC ID 7315331766, 3 clinicians

Practice addresses (Care Compare)

10300 Heritage St
Suite 250
San Antonio, TX 78216-3962
Phone (316) 369-0106

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1192980TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Puentes Medical Consultants LLC CurrentSince May 9, 2025 Accepting new patients
Doctors on the Go PLLC CurrentSince May 9, 2025 Accepting new patients

Locations

1164 Commerce Dr
Richardson, TX 75081
Phone (210) 693-5119

10300 Heritage St
Ste 250
San Antonio, TX 78216
Phone (316) 369-0106

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1742169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1205636370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29629 ELKHORN RDG",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780155104",
            "telephone_number": "210-793-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 HERITAGE ST STE 250",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782163962",
            "telephone_number": "210-375-4911",
            "fax_number": "210-855-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAZAR",
        "first_name": "DAVID",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1192980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.