Healthcare Provider Details

I. General information

NPI: 1982617841
Provider Name (Legal Business Name): CARLOS E ESCOBAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 11/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 N US HIGHWAY 87
BIG SPRING TX
79720-0283
US

IV. Provider business mailing address

3434 CLEARVIEW DR
SAN ANGELO TX
76904-8107
US

V. Phone/Fax

Practice location:
  • Phone: 432-267-8216
  • Fax:
Mailing address:
  • Phone: 325-942-9798
  • Fax: 325-942-6166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberH7727
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: