Individual provider Active NPI

Susana Pena Salazar, SA-C

  • Surgical Assistant
  • Cypress, TX
National Provider Identifier
1295209229
Registry record updated Feb 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
18-504 Issued in WI
Practice address
12507 Cove Landing Dr
Cypress, TX 77433-3082
Phone
(832) 769-7815
NPI assigned
Jan 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 18-504 WI Primary

Addresses

Primary practice location

12507 Cove Landing Dr
Cypress, TX 77433-3082

Mailing address

12507 Cove Landing Dr
Cypress, TX 77433-3082
Phone (832) 769-7815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18-504WIMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1547251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550880000000",
    "number": "1295209229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12507 COVE LANDING DR",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774333082",
            "telephone_number": "832-769-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12507 COVE LANDING DR",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774333082",
            "telephone_number": "832-769-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA SALAZAR",
        "first_name": "SUSANA",
        "credential": "SA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-12",
        "last_updated": "2019-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "WI",
            "license": "18-504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.