Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 37532 | TX |
Y | 103TC0700X | Clinical Psychologist | 37532 | TX |
NPI | 1003977554 |
---|---|
Provider Name | Eduardo Estevis |
First Address | Pharr, TX 78577-1614 |
Second Address | Edinburg, TX 78539-1405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 20/07/2017 |