Healthcare Provider Details

I. General information

NPI: 1396366126
Provider Name (Legal Business Name): DR. JESSICA TAYLOR ESKRIDGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 S MCCOLL RD
EDINBURG TX
78539-5503
US

IV. Provider business mailing address

500 S PRESTON ST
LOUISVILLE KY
40202-1702
US

V. Phone/Fax

Practice location:
  • Phone: 956-362-3594
  • Fax:
Mailing address:
  • Phone: 502-852-5193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: