Luis Joel Salcido, MS.CCC.SLP

Individual provider Active NPI Speech-Language Pathologist · Wink, TX

NPI 1295855203 · NPPES record last updated Jun 13, 2023

Key facts

NPI
1295855203
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
19516 (TX)
Practice address
200 N Rosy Dodd Ave.
Wink, TX 79789
Phone
(432) 527-3505
Fax
(432) 527-3505
NPI assigned
Mar 31, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 3

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

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
19516TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wink-Loving Isd Current
since Jun 18, 2023
Accepting new patients
Permian Basin Rehabilitation Center Past Accepting new patients
Permian Basin Rehabilitation Center for Crippled Children and Adults Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 19516 TX Yes

Addresses

Primary practice location

200 N Rosy Dodd Ave.
Wink, TX 79789

Mailing address

PO Box 637
Wink, TX 79789-0637
Phone (432) 527-3880

Other identifiers

IdentifierTypeStateIssuer
19516OtherTXSTATE LICENSE NUMBER
756002793MedicaidTX

Other providers in Wink, TX

All providers in Wink, TX · Speech-Language Pathologist in Texas

Sources for this page

Verify at the official NPI Registry.