Healthcare Provider Details

I. General information

NPI: 1093813925
Provider Name (Legal Business Name): ALEJANDRO ESQUIVEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALEX ESQUIVEL M.D.

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 12/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 E. 32ND STREET SUITE #308
AUSTIN TX
78705
US

IV. Provider business mailing address

1015 E. 32ND STREET SUITE #308
AUSTIN TX
78705
US

V. Phone/Fax

Practice location:
  • Phone: 512-472-1381
  • Fax: 512-472-9688
Mailing address:
  • Phone: 512-472-1381
  • Fax: 512-472-9688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberL1843
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberL1843
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: