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General NPI Number Information
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NPI Number | 1730416405
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Entity Type | Individual
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Provider Name | ESAIAS ISACC BACA D.C.
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Gender | Male
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Dates
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Enumeration Date | 11/17/2009
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Last Update Date | 01/31/2020
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Provider Practice Location Address
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Address Line | 2211 NORFOLK STREET 105
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City | HOUSTON
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State | TX
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Zip | 77098
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Country | US
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Telephone | 346-348-2222
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Fax | 712-522-3047
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Provider Business Mailing Address
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Address Line | 2211 NORFOLK ST STE 105
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City | HOUSTON
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State | TX
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Zip | 77098-4096
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Country | US
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Telephone | 713-522-9814
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Fax | 712-522-3047
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 11310
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License Number State | TX
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