Provider Demographics
NPI:1104794064
Name:BALTIERRA, ESPERANZA MARIE
Entity type:Individual
Prefix:MRS
First Name:ESPERANZA
Middle Name:MARIE
Last Name:BALTIERRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HOPE
Other - Middle Name:MARIE
Other - Last Name:BALTIERRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1720 SCOTTSDALE DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-7427
Mailing Address - Country:US
Mailing Address - Phone:214-620-9602
Mailing Address - Fax:
Practice Address - Street 1:1720 SCOTTSDALE DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-7427
Practice Address - Country:US
Practice Address - Phone:214-620-9602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant