Healthcare Provider Details
I. General information
NPI: 1457193658
Provider Name (Legal Business Name): CRISTINA MARIUXI KUON YENG ESCALANTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/10/2024
Last Update Date: 06/10/2024
Certification Date: 06/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2102 TREASURE HILLS BLVD
HARLINGEN TX
78550-8736
US
IV. Provider business mailing address
2102 TREASURE HILLS BLVD
HARLINGEN TX
78550-8736
US
V. Phone/Fax
- Phone: 956-296-1491
- Fax:
- Phone: 956-296-1491
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | BP10087663 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: