Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | D0123 | TX |
N | 208600000X | Surgeon | D0123 | TX |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | D0123 | TX |
NPI | 1154521490 |
---|---|
Provider Name | Hector A Escamilla |
First Address | San Antonio, TX 78299-2540 |
Second Address | San Antonio, TX 78215-1836 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2007 |
Last Update Date | 21/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110149502 | (05) | TX |
B22559 | (02) | TX |