Provider Demographics
NPI:1811294689
Name:FABIAN E ESPINOSA MD PA
Entity type:Organization
Organization Name:FABIAN E ESPINOSA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FABIAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ESPINOSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-574-1820
Mailing Address - Street 1:2710 HOSPITAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5701
Mailing Address - Country:US
Mailing Address - Phone:361-574-1820
Mailing Address - Fax:361-582-5610
Practice Address - Street 1:2710 HOSPITAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5701
Practice Address - Country:US
Practice Address - Phone:361-574-1820
Practice Address - Fax:361-582-5610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty