Healthcare Provider Details

I. General information

NPI: 1487524641
Provider Name (Legal Business Name): ELIZABETH ESQUIVEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2025
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3325 W WADLEY AVE
MIDLAND TX
79707-5714
US

IV. Provider business mailing address

3325 W WADLEY AVE
MIDLAND TX
79707-5714
US

V. Phone/Fax

Practice location:
  • Phone: 432-697-1484
  • Fax: 432-697-1489
Mailing address:
  • Phone: 432-697-1484
  • Fax: 432-697-1489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number303860
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: