Healthcare Provider Details

I. General information

NPI: 1245408780
Provider Name (Legal Business Name): JULIAN CAMILO ESCOBAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7515 GREENVILLE AVE STE 1030
DALLAS TX
75231-3866
US

IV. Provider business mailing address

7515 GREENVILLE AVE STE 1030
DALLAS TX
75231-3866
US

V. Phone/Fax

Practice location:
  • Phone: 214-224-0778
  • Fax: 214-224-0779
Mailing address:
  • Phone: 214-224-0778
  • Fax: 214-224-0779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberN0004
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: