Provider Demographics
NPI:1497004642
Name:ESPARZA, GLORIA RODRIGUEZ (CSFA)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:RODRIGUEZ
Last Name:ESPARZA
Suffix:
Gender:F
Credentials:CSFA
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Mailing Address - Street 1:540 MADISON OAK DR
Mailing Address - Street 2:SUITE 610
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3943
Mailing Address - Country:US
Mailing Address - Phone:210-496-2222
Mailing Address - Fax:210-352-5367
Practice Address - Street 1:540 MADISON OAK DR
Practice Address - Street 2:SUITE 610
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3943
Practice Address - Country:US
Practice Address - Phone:210-496-2222
Practice Address - Fax:210-352-5367
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2014-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX363AS0400X
TX137695246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant