Provider Demographics
NPI:1679506521
Name:ESPARZA, GINA M (MD)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:M
Last Name:ESPARZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:720 PLEASANTON RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78214-1306
Mailing Address - Country:US
Mailing Address - Phone:210-921-3800
Mailing Address - Fax:210-921-6620
Practice Address - Street 1:902 BANDERA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-4923
Practice Address - Country:US
Practice Address - Phone:210-431-4503
Practice Address - Fax:210-431-4531
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2015-01-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL2237207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147133601Medicaid
TX080180910OtherRR MEDICARE
TXH49291Medicare UPIN
TX147133601Medicaid