Provider Demographics
NPI:1437745320
Name:ESCOBEDO, ESMERALDA YAZMIN (OTA)
Entity Type:Individual
Prefix:MRS
First Name:ESMERALDA
Middle Name:YAZMIN
Last Name:ESCOBEDO
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7331 EDEN CROSSING LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1574
Mailing Address - Country:US
Mailing Address - Phone:713-732-4378
Mailing Address - Fax:
Practice Address - Street 1:7331 EDEN CROSSING LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-1574
Practice Address - Country:US
Practice Address - Phone:713-732-4378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX216556224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant