Healthcare Provider Details

I. General information

NPI: 1952438616
Provider Name (Legal Business Name): ERNESTO ESCOBAR DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14626 BELLAIRE BLVD
HOUSTON TX
77083-2506
US

IV. Provider business mailing address

14626 BELLAIRE BLVD
HOUSTON TX
77083-2506
US

V. Phone/Fax

Practice location:
  • Phone: 281-879-1786
  • Fax: 281-879-8147
Mailing address:
  • Phone: 281-879-1786
  • Fax: 281-879-8147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number20652
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: