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General NPI Number Information
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NPI Number | 1700530482
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Entity Type | Organization
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Legal Business Name | CARE DE LUXE
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Dates
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Enumeration Date | 02/10/2022
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 1033 LA POSADA DR # 210-10
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City | AUSTIN
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State | TX
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Zip | 78752-3842
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Country | US
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Telephone | 737-262-3374
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Fax | 949-437-3523
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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 | CEO, OWNER, NURSE PRACTITIONER
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Name | MR. JONATHAN LEE ESCOBEDO
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Credential | MSN, APRN, FNP-BC
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Telephone | 737-262-3374
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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