Healthcare Provider Details

I. General information

NPI: 1710867296
Provider Name (Legal Business Name): JACQUELINE ESCOBAR SLP-CF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 ARCADIA PATH
SAN ANTONIO TX
78245
US

IV. Provider business mailing address

6611 SWISS OAKS
SAN ANTONIO TX
78227-1267
US

V. Phone/Fax

Practice location:
  • Phone: 210-448-9111
  • Fax:
Mailing address:
  • Phone: 210-514-6269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number124332
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: