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General NPI Number Information
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NPI Number | 1376068882
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Entity Type | Individual
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Provider Name | JONATHAN LEE ESCOBEDO MSN, RN, FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 08/04/2017
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Last Update Date | 08/11/2023
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Provider Practice Location Address
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Address Line | 1909 E 38TH 1/2 ST STE C
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City | AUSTIN
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State | TX
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Zip | 78723-5749
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Country | US
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Telephone | 737-262-3374
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Fax | 512-391-9703
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Provider Business Mailing Address
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Address Line | 806 E 13TH ST
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City | AUSTIN
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State | TX
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Zip | 78702-1013
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Country | US
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Telephone | 512-914-2738
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP134760
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License Number State | TX
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