Healthcare Provider Details

I. General information

NPI: 1447058094
Provider Name (Legal Business Name): SALYNA MARIE ESCOBAR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 W 7TH ST
FORT WORTH TX
76107-2532
US

IV. Provider business mailing address

6524 MEADOWLARK LN E
WATAUGA TX
76148-1734
US

V. Phone/Fax

Practice location:
  • Phone: 817-725-4337
  • Fax:
Mailing address:
  • Phone: 940-224-3084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1171396
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: