Provider Demographics
NPI:1033360995
Name:ESPARZA, LUIS MIGUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:MIGUEL
Last Name:ESPARZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 FM 300
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-6235
Mailing Address - Country:US
Mailing Address - Phone:806-894-7842
Mailing Address - Fax:806-894-3378
Practice Address - Street 1:712 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:TX
Practice Address - Zip Code:79714-3617
Practice Address - Country:US
Practice Address - Phone:432-464-2450
Practice Address - Fax:432-464-2566
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6966207Q00000X
CAA110384207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEM085ZMedicare PIN