Healthcare Provider Details

I. General information

NPI: 1912874371
Provider Name (Legal Business Name): MARITZA ESQUIVEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1512 ECTOR CIR
MESQUITE TX
75150-5932
US

IV. Provider business mailing address

1512 ECTOR CIR
MESQUITE TX
75150-5932
US

V. Phone/Fax

Practice location:
  • Phone: 469-684-4176
  • Fax:
Mailing address:
  • Phone: 469-684-4176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT92574
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: