Healthcare Provider Details

I. General information

NPI: 1205385523
Provider Name (Legal Business Name): JOSE ERNESTO ESCOBAR-FERIX RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2016
Last Update Date: 12/07/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31315 FM 2920 RD STE 16A
WALLER TX
77484-8022
US

IV. Provider business mailing address

19472 TAHOKA SPRINGS DR
KATY TX
77449-5299
US

V. Phone/Fax

Practice location:
  • Phone: 936-372-2673
  • Fax:
Mailing address:
  • Phone: 281-723-0907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number35773
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1179135
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: