Provider Demographics
NPI:1093355521
Name:ESCOBAR-CHENG, VIRGINIA NOEMI (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:NOEMI
Last Name:ESCOBAR-CHENG
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18511 HIGHLANDER MEDICS STREET
Mailing Address - Street 2:WBAMC
Mailing Address - City:FORT BLISS
Mailing Address - State:TX
Mailing Address - Zip Code:79936
Mailing Address - Country:US
Mailing Address - Phone:915-569-3213
Mailing Address - Fax:
Practice Address - Street 1:18511 HIGHLANDER MEDICS STREET
Practice Address - Street 2:WBAMC
Practice Address - City:FORT BLISS
Practice Address - State:TX
Practice Address - Zip Code:79936
Practice Address - Country:US
Practice Address - Phone:915-569-3213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-13
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110-007366363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant