Provider Demographics
NPI:1801232632
Name:ESCOBER, MERCEDITA R
Entity Type:Individual
Prefix:
First Name:MERCEDITA
Middle Name:R
Last Name:ESCOBER
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 1:2647 KAREN CT
Mailing Address - Street 2:#514
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-1221
Mailing Address - Country:US
Mailing Address - Phone:702-610-7552
Mailing Address - Fax:702-369-5605
Practice Address - Street 1:2647 KAREN CT
Practice Address - Street 2:#514
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-1221
Practice Address - Country:US
Practice Address - Phone:702-610-7552
Practice Address - Fax:702-369-5605
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner