Healthcare Provider Details

I. General information

NPI: 1356011753
Provider Name (Legal Business Name): MANUEL ESQUIVEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 09/16/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22485 TOMBALL PKWY STE 2100
HOUSTON TX
77070-1560
US

IV. Provider business mailing address

11800 FM 1960 RD W
HOUSTON TX
77065-3840
US

V. Phone/Fax

Practice location:
  • Phone: 281-955-2650
  • Fax: 291-955-5875
Mailing address:
  • Phone: 281-955-7577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: