Provider Demographics
NPI:1306405105
Name:ESCAMILLA, PATRICK LAWRENCE MARSTON (FNP-C)
Entity Type:Individual
Prefix:
First Name:PATRICK LAWRENCE
Middle Name:MARSTON
Last Name:ESCAMILLA
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15882 CHAMPION FOREST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7141
Mailing Address - Country:US
Mailing Address - Phone:281-783-8162
Mailing Address - Fax:
Practice Address - Street 1:12141 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2408
Practice Address - Country:US
Practice Address - Phone:281-588-8110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141703363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily