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NPI Code Detail

MEDICARE: KRISTIN VALDERAS ESCAMILLA M.D.

MEDICARE: KRISTIN VALDERAS ESCAMILLA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianBP1-0035467TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811121668
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN VALDERAS ESCAMILLA M.D.
Provider Business Mailing Address
First Line : 3501 MILLS AVE
Second Line :
City : AUSTIN
State : TX
Zip : 78731-6309
Country : US
Telephone Number : 512-324-2000
Fax Number :
Provider Business Practice Location Address
First Line : 6600 E BEN WHITE BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78741-7537
Country : US
Telephone Number : 512-804-3770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2009
Last Update Date : 08/15/2019

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