MEDICARE: GABRIEL ESPINOZA FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1071477	TX

General Provider Information

NPI Number	:	1275281172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIEL ESPINOZA FNP

Provider Business Mailing Address
First Line	:	13800 EASTLAKE BLVD STE 400
Second Line	:
City	:	HORIZON CITY
State	:	TX
Zip	:	79928-7389
Country	:	US
Telephone Number	:	915-577-1134
Fax Number	:	915-852-4767

Provider Business Practice Location Address
First Line	:	13800 EASTLAKE BLVD STE 400
Second Line	:
City	:	HORIZON CITY
State	:	TX
Zip	:	79928-7389
Country	:	US
Telephone Number	:	915-577-1134
Fax Number	:	915-852-4767

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2022
Last Update Date	:	03/10/2022

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