Basic Information
Provider Information
NPI: 1336779081
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ESCOBEDO
FirstName: MONICA
MiddleName: RODRIGUEZ
NamePrefix:  
NameSuffix:  
Credential: MSN, APRN, FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1801 N BEDELL AVE
Address2:  
City: DEL RIO
State: TX
PostalCode: 788408001
CountryCode: US
TelephoneNumber: 8307689200
FaxNumber:  
Practice Location
Address1: 1800 N BEDELL
Address2:  
City: DEL RIO
State: TX
PostalCode: 78840
CountryCode: US
TelephoneNumber: 8307689200
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/22/2020
LastUpdateDate: 02/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP144673TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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