Healthcare Provider Details

I. General information

NPI: 1861848202
Provider Name (Legal Business Name): CELIA CRISTINA ESCAMILLA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 UNIVERSITY BLVD
ROUND ROCK TX
78665-1032
US

IV. Provider business mailing address

PO BOX 840003
DALLAS TX
75284-0003
US

V. Phone/Fax

Practice location:
  • Phone: 512-509-0100
  • Fax: 512-218-6330
Mailing address:
  • Phone: 254-724-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberR9750
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: