Healthcare Provider Details

I. General information

NPI: 1053585349
Provider Name (Legal Business Name): HEATHER MICHELE ESQUIVEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12606 GREENVILLE AVE STE 200
DALLAS TX
75243-1923
US

IV. Provider business mailing address

5402 ARAPAHO RD
DALLAS TX
75248-6905
US

V. Phone/Fax

Practice location:
  • Phone: 469-780-4590
  • Fax: 833-450-0375
Mailing address:
  • Phone: 469-780-4590
  • Fax: 833-450-0375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License NumberQ7362
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberQ7362
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: