Healthcare Provider Details

I. General information

NPI: 1669427175
Provider Name (Legal Business Name): EDWARD ESCOBAR
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 PEASE ST
HARLINGEN TX
78550-8307
US

IV. Provider business mailing address

2121 PEASE SUITE 601
HARLINGEN TX
78550
US

V. Phone/Fax

Practice location:
  • Phone: 956-423-0112
  • Fax: 956-423-0188
Mailing address:
  • Phone: 956-423-0112
  • Fax: 956-423-0188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: