Healthcare Provider Details

I. General information

NPI: 1659366805
Provider Name (Legal Business Name): HAROLD B ESKEW III PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 01/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5656 BEE CAVES RD SUITE K-200
AUSTIN TX
78746-5280
US

IV. Provider business mailing address

8300 N LAMAR BLVD STE 200A
AUSTIN TX
78753-5976
US

V. Phone/Fax

Practice location:
  • Phone: 512-329-6644
  • Fax: 512-891-6399
Mailing address:
  • Phone: 512-782-9312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA02662
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: