Healthcare Provider Details

I. General information

NPI: 1760472682
Provider Name (Legal Business Name): LOUIS HECTOR ESQUIVEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2005
Last Update Date: 07/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3740 COLONY DR SUITE LL102
SAN ANTONIO TX
78230-2234
US

IV. Provider business mailing address

3740 COLONY DR SUITE LL102
SAN ANTONIO TX
78230-2234
US

V. Phone/Fax

Practice location:
  • Phone: 210-745-0918
  • Fax: 210-745-0590
Mailing address:
  • Phone: 210-745-0918
  • Fax: 210-745-0590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH2363
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: