Healthcare Provider Details

I. General information

NPI: 1801394119
Provider Name (Legal Business Name): MAYRA ESQUIVEL RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2018
Last Update Date: 02/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9410 DUGAS DR # 118
SAN ANTONIO TX
78245-1869
US

IV. Provider business mailing address

234 W BANDERA RD
BOERNE TX
78006-2805
US

V. Phone/Fax

Practice location:
  • Phone: 210-447-7041
  • Fax:
Mailing address:
  • Phone: 210-771-3166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: