Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | M5150 | TX |
NPI | 1144424920 |
---|---|
Provider Name | Jose Fernando Escobar |
First Address | Denton, TX 76201-2376 |
Second Address | Denton, TX 76201-2376 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 01/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
194031403 | (05) | TX |
194031404 | (05) | TX |