Healthcare Provider Details

I. General information

NPI: 1265918387
Provider Name (Legal Business Name): BETTY ESCALANTE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2018
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2385 SANTA MARIA LN
CORPUS CHRISTI TX
78415-6895
US

IV. Provider business mailing address

2385 SANTA MARIA LN
CORPUS CHRISTI TX
78415-6895
US

V. Phone/Fax

Practice location:
  • Phone: 361-549-0606
  • Fax:
Mailing address:
  • Phone: 361-549-0606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP137988
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: