Healthcare Provider Details

I. General information

NPI: 1619636198
Provider Name (Legal Business Name): BETZA ESCOBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2021
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11111 MIDHURST DR
HOUSTON TX
77072-1929
US

IV. Provider business mailing address

11111 MIDHURST DR
HOUSTON TX
77072-1929
US

V. Phone/Fax

Practice location:
  • Phone: 281-925-8913
  • Fax: 832-849-0937
Mailing address:
  • Phone: 281-925-8913
  • Fax: 832-849-0937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: