Healthcare Provider Details

I. General information

NPI: 1982661518
Provider Name (Legal Business Name): ANTONIO ESPARZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 12/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W SAM HOUSTON ST SUITE 1
PHARR TX
78577-5217
US

IV. Provider business mailing address

900 W SAM HOUSTON ST SUITE 1
PHARR TX
78577-5217
US

V. Phone/Fax

Practice location:
  • Phone: 956-783-1000
  • Fax: 956-783-9679
Mailing address:
  • Phone: 956-783-1000
  • Fax: 956-783-9679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberH7411
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: