Healthcare Provider Details

I. General information

NPI: 1306391479
Provider Name (Legal Business Name): MIGUEL ALEJANDRO ESCOBAR PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E RIDGE RD STE 300
MCALLEN TX
78503-1508
US

IV. Provider business mailing address

PO BOX 3046
MALVERN PA
19355-0746
US

V. Phone/Fax

Practice location:
  • Phone: 956-630-5522
  • Fax: 956-682-7730
Mailing address:
  • Phone: 956-630-5522
  • Fax: 956-682-7730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA10690
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: