Provider Demographics
NPI:1093813925
Name:ESQUIVEL, ALEJANDRO (MD)
Entity Type:Individual
Prefix:MR
First Name:ALEJANDRO
Middle Name:
Last Name:ESQUIVEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:ESQUIVEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1015 E. 32ND STREET
Mailing Address - Street 2:SUITE #308
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705
Mailing Address - Country:US
Mailing Address - Phone:512-472-1381
Mailing Address - Fax:512-472-9688
Practice Address - Street 1:1015 E. 32ND STREET
Practice Address - Street 2:SUITE #308
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705
Practice Address - Country:US
Practice Address - Phone:512-472-1381
Practice Address - Fax:512-472-9688
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEL1843208600000X
TXL1843208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4201439OtherBCBS OF TX BLUELINK
TX8F0312OtherBC/BS OF TEXAS
TX1452617-01Medicaid
TX0083GUOtherBCBS OF TX
TX145261701Medicaid
TX8F0312OtherBC/BS OF TEXAS
TX00274QMedicare ID - Type UnspecifiedMEDICARE