Basic Information
| Provider Information | |||||||||
| NPI: | 1225272453 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ESQUIVEL-VANEGAS | ||||||||
| FirstName: | GERMAN | ||||||||
| MiddleName: | ROMAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 W TRENTON RD | ||||||||
| Address2: | ATTN: PRACTICE ADMINISTRATOR-HOSPITALIST | ||||||||
| City: | EDINBURG | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785393413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9562892207 | ||||||||
| FaxNumber: | 9562895040 | ||||||||
| Practice Location | |||||||||
| Address1: | 1102 W TRENTON RD | ||||||||
| Address2: | |||||||||
| City: | EDINBURG | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785399105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9562135111 | ||||||||
| FaxNumber: | 9562895040 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2009 | ||||||||
| LastUpdateDate: | 06/30/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | P1860 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine | 208M00000X | P1860 | TX | N | Allopathic & Osteopathic Physicians | Hospitalist | 207P00000X | P1860 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 8DJ936 | 01 | TX | BCBS TX | OTHER | 309402101 | 05 | TX | MEDICAID |