Healthcare Provider Details

I. General information

NPI: 1205727682
Provider Name (Legal Business Name): CHERYL ELAINE ESCUE SPECIALIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 07/14/2025
Certification Date: 07/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15336 LIBRA AVE
PRIDE LA
70770-9600
US

IV. Provider business mailing address

15336 LIBRA AVE
PRIDE LA
70770-9600
US

V. Phone/Fax

Practice location:
  • Phone: 225-330-9166
  • Fax:
Mailing address:
  • Phone: 225-330-9166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: