Healthcare Provider Details

I. General information

NPI: 1528308715
Provider Name (Legal Business Name): MICHELLE RENE ESCUE F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2013
Last Update Date: 02/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 BALCONES DR
AUSTIN TX
78731-4257
US

IV. Provider business mailing address

217 GRAND ISLE DR
ROUND ROCK TX
78665-2828
US

V. Phone/Fax

Practice location:
  • Phone: 512-371-9885
  • Fax: 512-371-9371
Mailing address:
  • Phone: 512-433-0733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number717406
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: