Healthcare Provider Details

I. General information

NPI: 1023261856
Provider Name (Legal Business Name): JESUS FERNANDO ESCARZAGA RPA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2008
Last Update Date: 10/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4930 OSBORNE SUITE H
EL PASO TX
79922
US

IV. Provider business mailing address

4930 OSBORNE DR SUITE H
EL PASO TX
79922-1041
US

V. Phone/Fax

Practice location:
  • Phone: 915-740-5122
  • Fax:
Mailing address:
  • Phone: 915-740-5122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code243U00000X
TaxonomyRadiology Practitioner Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: