Healthcare Provider Details

I. General information

NPI: 1588973721
Provider Name (Legal Business Name): MICHELLE BUFKIN ESCOBEDO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2010
Last Update Date: 04/10/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1712 N ACCESS RD
CLYDE TX
79510-3352
US

IV. Provider business mailing address

PO BOX 2435
ALBANY TX
76430-8020
US

V. Phone/Fax

Practice location:
  • Phone: 325-893-4010
  • Fax: 325-893-4035
Mailing address:
  • Phone: 325-893-4010
  • Fax: 325-893-4035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number625926
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: