Healthcare Provider Details
I. General information
NPI: 1780807941
Provider Name (Legal Business Name): ANTHONY JAMES ESQUIBEL D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/10/2007
Last Update Date: 08/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4002 BROADWAY BLVD. #101 ELITE HEALTHCARE GARLAND
GARLAND TX
75043
US
IV. Provider business mailing address
4002 BROADWAY BLVD. #101 ELITE HEALTHCARE GARLAND
GARLAND TX
75043
US
V. Phone/Fax
- Phone: 214-556-2150
- Fax: 214-556-2155
- Phone: 214-556-2150
- Fax: 214-556-2155
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | 8133 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: