MEDICARE: DR. TERRY FULLER ESKA M.D.

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	207R00000X	Internal Medicine Physician	E6773	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00AN27	OTHER	TX	BLUE CROSS
2	09739432	OTHER	TX	097394302

General Provider Information

NPI Number	:	1558470864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRY FULLER ESKA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1837
Second Line	:
City	:	GONZALES
State	:	TX
Zip	:	78629-1337
Country	:	US
Telephone Number	:	830-672-4995
Fax Number	:

Provider Business Practice Location Address
First Line	:	1605 N SARAH DEWITT DR
Second Line	:
City	:	GONZALES
State	:	TX
Zip	:	78629-2700
Country	:	US
Telephone Number	:	830-672-4995
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	05/11/2026

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