Healthcare Provider Details

I. General information

NPI: 1619475233
Provider Name (Legal Business Name): MISS ASHANTY ESQUIVEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2018
Last Update Date: 01/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7935 FALL GLEN DR
HOUSTON TX
77040-6043
US

IV. Provider business mailing address

7935 FALL GLEN DR
HOUSTON TX
77040-6043
US

V. Phone/Fax

Practice location:
  • Phone: 832-384-3058
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number38014
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: