Healthcare Provider Details

I. General information

NPI: 1740313907
Provider Name (Legal Business Name): GISELLE VIRGINIA ESCALONA MS, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 12/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 PRESTON RD
PLANO TX
75024-3214
US

IV. Provider business mailing address

1935 MEDICAL DISTRICT DR
DALLAS TX
75235-7701
US

V. Phone/Fax

Practice location:
  • Phone: 469-303-7000
  • Fax:
Mailing address:
  • Phone: 214-456-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number663651
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: