Healthcare Provider Details

I. General information

NPI: 1730914193
Provider Name (Legal Business Name): RONDIE ESCAMILLA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2327 W LINE RD
WHITESBORO TX
76273-7160
US

IV. Provider business mailing address

2327 W LINE RD
WHITESBORO TX
76273-7160
US

V. Phone/Fax

Practice location:
  • Phone: 903-624-2964
  • Fax:
Mailing address:
  • Phone: 903-624-2964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number604347
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: