Provider Demographics
NPI:1831104645
Name:LOCOCO, SALVATORE J (MD)
Entity type:Individual
Prefix:
First Name:SALVATORE
Middle Name:J
Last Name:LOCOCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-0002
Mailing Address - Country:US
Mailing Address - Phone:806-743-2340
Mailing Address - Fax:806-743-1775
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0002
Practice Address - Country:US
Practice Address - Phone:806-743-2340
Practice Address - Fax:806-743-1775
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5786207VX0201X
IL036123856207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139534502Medicaid
TX8B5593OtherBCBS
TXP00261072OtherRAILROAD MEDICARE
TXP00261072OtherRAILROAD MEDICARE
TX8D9048Medicare PIN