Provider Demographics
NPI:1164593836
Name:ESCOBAR, ROMEO LUIS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ROMEO
Middle Name:LUIS
Last Name:ESCOBAR
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 E TYLER AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7339
Mailing Address - Country:US
Mailing Address - Phone:956-421-2153
Mailing Address - Fax:956-421-2928
Practice Address - Street 1:1706 E TYLER AVE STE 5
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7339
Practice Address - Country:US
Practice Address - Phone:956-421-2153
Practice Address - Fax:956-421-2928
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX073901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00925EMedicare ID - Type Unspecified