Provider Demographics
NPI:1346321999
Name:ESCALANTE, DANTE (MD)
Entity Type:Individual
Prefix:
First Name:DANTE
Middle Name:
Last Name:ESCALANTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4364 THOUSAND OAKS DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-2153
Mailing Address - Country:US
Mailing Address - Phone:210-599-1288
Mailing Address - Fax:210-599-3486
Practice Address - Street 1:4364 THOUSAND OAKS DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-2153
Practice Address - Country:US
Practice Address - Phone:210-599-1288
Practice Address - Fax:210-599-3486
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3789207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF67928Medicare UPIN
TXN73UMedicare ID - Type Unspecified