Healthcare Provider Details

I. General information

NPI: 1801903893
Provider Name (Legal Business Name): MICHAEL ESCAMILLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 06/12/2020
Certification Date: 06/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 VICTORIA LN STE 13
HARLINGEN TX
78550-3228
US

IV. Provider business mailing address

2102 TREASURE HILLS BLVD STE 3.144.06
HARLINGEN TX
78550-8736
US

V. Phone/Fax

Practice location:
  • Phone: 956-296-3821
  • Fax: 956-296-3820
Mailing address:
  • Phone: 956-296-1437
  • Fax: 956-296-6842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberL2236
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: