Healthcare Provider Details

I. General information

NPI: 1457922981
Provider Name (Legal Business Name): MARY ESQUIVEL CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2021
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3537 S INTERSTATE 35 E STE 214
DENTON TX
76210-6814
US

IV. Provider business mailing address

3537 S INTERSTATE 35 E STE 214
DENTON TX
76210-6814
US

V. Phone/Fax

Practice location:
  • Phone: 940-320-2745
  • Fax: 940-565-1215
Mailing address:
  • Phone: 940-320-2745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1017772
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: