Healthcare Provider Details

I. General information

NPI: 1013456912
Provider Name (Legal Business Name): GRISELDA ESQUIVEL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 02/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20935 US HIGHWAY 281 N
SAN ANTONIO TX
78258-7587
US

IV. Provider business mailing address

20935 US HIGHWAY 281 N
SAN ANTONIO TX
78258-7587
US

V. Phone/Fax

Practice location:
  • Phone: 830-279-4691
  • Fax:
Mailing address:
  • Phone: 830-279-4691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number816397
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP132412
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: