Provider Demographics
NPI:1659903714
Name:ESPINOZA, CONNIE
Entity Type:Individual
Prefix:MRS
First Name:CONNIE
Middle Name:
Last Name:ESPINOZA
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 1:633 ASH ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-8019
Mailing Address - Country:US
Mailing Address - Phone:806-213-0030
Mailing Address - Fax:806-213-0036
Practice Address - Street 1:633 ASH ST
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-8019
Practice Address - Country:US
Practice Address - Phone:806-213-0030
Practice Address - Fax:806-213-0036
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1659903714OtherPERSONAL ASSISTIVE SERVICES