Basic Information
| Provider Information | |||||||||
| NPI: | 1083093660 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ESPARZA | ||||||||
| FirstName: | MARY JOSEPHINE | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11130 CHRISTUS HLS | ||||||||
| Address2: | MEDICAL PLAZA 3, SUITE 201 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782513585 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2107039045 | ||||||||
| FaxNumber: | 2107039009 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 TRANS MOUNTAIN RD STE B | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152158400 | ||||||||
| FaxNumber: | 9156129254 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2015 | ||||||||
| LastUpdateDate: | 07/26/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | R7206 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.