Healthcare Provider Details

I. General information

NPI: 1861183931
Provider Name (Legal Business Name): RACHEL ESCARSEGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2023
Last Update Date: 05/18/2023
Certification Date: 05/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 ROADRUNNER
LAS CRUCES NM
88011
US

IV. Provider business mailing address

6916 ESCONDIDO DR APT A
EL PASO TX
79912-3163
US

V. Phone/Fax

Practice location:
  • Phone: 575-386-5800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number215470
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: