MEDICARE: DR. PEDRO ESMERALDA ESTORQUE JR. MD

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	207Q00000X	Family Medicine Physician	J9017	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548263593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEDRO ESMERALDA ESTORQUE JR. MD

Provider Business Mailing Address
First Line	:	500 FORT WORTH DR STE 140
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76201-7527
Country	:	US
Telephone Number	:	940-320-0505
Fax Number	:	940-320-0506

Provider Business Practice Location Address
First Line	:	500 FORT WORTH DR STE 140
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76201-7527
Country	:	US
Telephone Number	:	940-320-0505
Fax Number	:	940-320-0506

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	11/22/2023

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