Healthcare Provider Details

I. General information

NPI: 1790316149
Provider Name (Legal Business Name): GHARY ESGUERRA FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2020
Last Update Date: 02/03/2020
Certification Date: 02/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 THUNDERBIRD AVE
MCALLEN TX
78504-4265
US

IV. Provider business mailing address

2600 THUNDERBIRD AVE
MCALLEN TX
78504-4265
US

V. Phone/Fax

Practice location:
  • Phone: 956-624-6997
  • Fax:
Mailing address:
  • Phone: 956-624-6997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP144913
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: