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General NPI Number Information
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NPI Number | 1114125408
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Entity Type | Individual
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Provider Name | RICARDO ESCAMILLA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/06/2007
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 2200 BERGQUIST DR SUITE #1
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City | LACKLAND A F B
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State | TX
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Zip | 78236-9907
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Country | US
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Telephone | 210-292-7395
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Fax |
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Provider Business Mailing Address
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Address Line | 6770 COUNTRY FIELD DR
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City | SAN ANTONIO
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State | TX
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Zip | 78240-4403
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Country | US
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Telephone | 210-877-6233
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01063953A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M9266
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License Number State | TX
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