Healthcare Provider Details

I. General information

NPI: 1871816553
Provider Name (Legal Business Name): RACHAEL LYNELLE ESQUIBEL CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHAEL LYNELLE HERNANDEZ

II. Dates (important events)

Enumeration Date: 03/09/2010
Last Update Date: 03/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4502 MEDICAL DR
SAN ANTONIO TX
78229-4402
US

IV. Provider business mailing address

7703 FLOYD CURL DR # MC7977
SAN ANTONIO TX
78229-3901
US

V. Phone/Fax

Practice location:
  • Phone: 210-450-9000
  • Fax:
Mailing address:
  • Phone: 210-450-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number679329
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: