Healthcare Provider Details

I. General information

NPI: 1992909550
Provider Name (Legal Business Name): CRISTEL ESCALONA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 08/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W. UNIVERSITY DRIVE UTRGV STUDENT HEALTH
EDINBURG TX
78539-2835
US

IV. Provider business mailing address

2102 TREASURE HILLS BLVD. #3.144.05
HARLINGEN TX
78550-2835
US

V. Phone/Fax

Practice location:
  • Phone: 956-665-2511
  • Fax: 956-665-2512
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberBP1-0017356
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: