Provider Demographics
NPI:1215597489
Name:ESCALANTE, JOSHUA RAFAEL
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:RAFAEL
Last Name:ESCALANTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 E 16TH ST
Mailing Address - Street 2:
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79720-4742
Mailing Address - Country:US
Mailing Address - Phone:432-816-2937
Mailing Address - Fax:
Practice Address - Street 1:911 E 16TH ST
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-4742
Practice Address - Country:US
Practice Address - Phone:432-816-2937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist