Basic Information
Provider Information
NPI: 1356708556
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ESQUIBEL
FirstName: LINDA
MiddleName: VERONICA
NamePrefix:  
NameSuffix:  
Credential: PNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1745 BROWNFIELD RD
Address2:  
City: BROWNSVILLE
State: TX
PostalCode: 785207745
CountryCode: US
TelephoneNumber: 9564598199
FaxNumber:  
Practice Location
Address1: 95 E PRICE RD
Address2: BLDG F
City: BROWNSVILLE
State: TX
PostalCode: 785213578
CountryCode: US
TelephoneNumber: 9565046080
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/20/2016
LastUpdateDate: 01/20/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200XAP129892TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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