Provider Demographics
NPI:1568828218
Name:CARROLL, ESMERALDA
Entity Type:Individual
Prefix:
First Name:ESMERALDA
Middle Name:
Last Name:CARROLL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 LINDBERG AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2925
Mailing Address - Country:US
Mailing Address - Phone:956-777-9320
Mailing Address - Fax:956-340-6253
Practice Address - Street 1:621 LINDBERG AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2925
Practice Address - Country:US
Practice Address - Phone:956-777-9320
Practice Address - Fax:956-340-6253
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-11
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80460237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter