Provider Demographics
NPI:1235585381
Name:ESPINOSA, DANIEL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:ESPINOSA
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 1:601 E SAN ANTONIO ST STE 102W
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-6051
Mailing Address - Country:US
Mailing Address - Phone:361-582-0861
Mailing Address - Fax:
Practice Address - Street 1:605 E SAN ANTONIO ST STE 330E
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-6028
Practice Address - Country:US
Practice Address - Phone:361-576-9386
Practice Address - Fax:361-576-9502
Is Sole Proprietor?:No
Enumeration Date:2016-05-08
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX650499207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine