Healthcare Provider Details

I. General information

NPI: 1790792687
Provider Name (Legal Business Name): CARMEN G. ESCANDON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 S. MESA HILLS SUITE C-2
EL PASO TX
79912
US

IV. Provider business mailing address

550 S. MESA HILLS SUITE C-2
EL PASO TX
79912
US

V. Phone/Fax

Practice location:
  • Phone: 915-845-5700
  • Fax: 915-845-5706
Mailing address:
  • Phone: 915-845-5700
  • Fax: 915-845-5706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL3959
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: