Healthcare Provider Details

I. General information

NPI: 1295278430
Provider Name (Legal Business Name): FELIX R ESCOBEDO JR. NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2016
Last Update Date: 05/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 WATERS AVE
DEL RIO TX
78840-6280
US

IV. Provider business mailing address

109 WATERS AVE
DEL RIO TX
78840-6280
US

V. Phone/Fax

Practice location:
  • Phone: 830-313-1462
  • Fax:
Mailing address:
  • Phone: 830-313-1462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP132647
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: