Provider Demographics
NPI:1235263229
Name:ESQUIVEL, JOSE FERNANDO (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:FERNANDO
Last Name:ESQUIVEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6111 TEZEL RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-4196
Mailing Address - Country:US
Mailing Address - Phone:210-286-7007
Mailing Address - Fax:210-520-0097
Practice Address - Street 1:6111 TEZEL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-4196
Practice Address - Country:US
Practice Address - Phone:210-286-7007
Practice Address - Fax:210-520-0097
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AW030OtherBCBS OF TEXAS