Provider Demographics
NPI:1255580007
Name:ESPEJO, HILDA GARCIA (PT)
Entity type:Individual
Prefix:
First Name:HILDA
Middle Name:GARCIA
Last Name:ESPEJO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:HILDA
Other - Middle Name:MARCOS
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:3102 ASPEN LANE
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578
Mailing Address - Country:US
Mailing Address - Phone:901-485-9285
Mailing Address - Fax:
Practice Address - Street 1:3102 ASPEN LN
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-2938
Practice Address - Country:US
Practice Address - Phone:901-485-9285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2631225100000X
TX1205253225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR000000000Medicaid