Provider Demographics
NPI:1922124122
Name:ESPARZA, NORMA ESTELLA (DC)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:ESTELLA
Last Name:ESPARZA
Suffix:
Gender:F
Credentials:DC
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 471669
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76147-1401
Mailing Address - Country:US
Mailing Address - Phone:817-336-9355
Mailing Address - Fax:
Practice Address - Street 1:2701 W BERRY ST
Practice Address - Street 2:STE. 130
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-2360
Practice Address - Country:US
Practice Address - Phone:817-336-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6364111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX752845044OtherTAX ID