Provider Demographics
NPI:1598933863
Name:ESPARZA, COSTA LUNA, PRECIADO, PLLC
Entity Type:Organization
Organization Name:ESPARZA, COSTA LUNA, PRECIADO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPARZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-783-1000
Mailing Address - Street 1:900 W SAM HOUSTON BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-5215
Mailing Address - Country:US
Mailing Address - Phone:956-783-1000
Mailing Address - Fax:956-783-9679
Practice Address - Street 1:1206 S F ST STE 1
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-6783
Practice Address - Country:US
Practice Address - Phone:956-444-0844
Practice Address - Fax:956-444-0845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7411208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty