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General NPI Number Information
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NPI Number | 1023905288
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Entity Type | Individual
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Provider Name | ILIANA ESCOBEDO
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Gender | Female
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 1519 E BUSTAMANTE ST STE B
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City | LAREDO
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State | TX
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Zip | 78041-5305
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Country | US
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Telephone | 956-568-3009
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Fax | 956-568-3048
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Provider Business Mailing Address
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Address Line | 1504 CENTENO LN
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City | RIO BRAVO
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State | TX
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Zip | 78046-7819
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Country | US
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Telephone | 956-229-5456
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 824299
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP1196374
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License Number State | TX
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