Provider Demographics
NPI:1093882466
Name:ESCOBAR, VERONICA ANN (DO)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:ANN
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7622 LOUIS PASTEUR DR STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4019
Mailing Address - Country:US
Mailing Address - Phone:210-610-3859
Mailing Address - Fax:210-641-2277
Practice Address - Street 1:7622 LOUIS PASTEUR DR STE 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4019
Practice Address - Country:US
Practice Address - Phone:210-610-3859
Practice Address - Fax:210-641-2277
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1659207Q00000X, 207QG0300X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1963712-02Medicaid
TX8L16893Medicare PIN