Provider Demographics
NPI:1831137173
Name:ESQUIVEL, CARLOS ROBERT (MD)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:ROBERT
Last Name:ESQUIVEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2679
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78299-2679
Mailing Address - Country:US
Mailing Address - Phone:210-616-0096
Mailing Address - Fax:210-614-1003
Practice Address - Street 1:1100 WILFORD HALL LOOP BLDG 4554
Practice Address - Street 2:
Practice Address - City:JBSA LACKLAND
Practice Address - State:TX
Practice Address - Zip Code:78236
Practice Address - Country:US
Practice Address - Phone:210-292-6225
Practice Address - Fax:210-292-6453
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1990207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112782101Medicaid
TX112782101Medicaid
TX8D7753Medicare PIN
TXF71377Medicare UPIN