Provider Demographics
NPI:1306044227
Name:FAMILY MEDICINE & AESTHETICS PA
Entity Type:Organization
Organization Name:FAMILY MEDICINE & AESTHETICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:GEORGINA
Authorized Official - Last Name:ESCANDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-845-5700
Mailing Address - Street 1:550 S. MESA HILLS DRIVE
Mailing Address - Street 2:SUITE C-2
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912
Mailing Address - Country:US
Mailing Address - Phone:915-845-5700
Mailing Address - Fax:915-591-9215
Practice Address - Street 1:550 S. MESA HILLS DRIVE
Practice Address - Street 2:SUITE C-2
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912
Practice Address - Country:US
Practice Address - Phone:915-845-5700
Practice Address - Fax:915-591-9215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3959261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care