Provider Demographics
NPI:1194351825
Name:ESCALANTE, EMILIANO JOSE (LVN)
Entity type:Individual
Prefix:
First Name:EMILIANO
Middle Name:JOSE
Last Name:ESCALANTE
Suffix:
Gender:M
Credentials:LVN
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 985
Mailing Address - Street 2:
Mailing Address - City:JOURDANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78026-0985
Mailing Address - Country:US
Mailing Address - Phone:830-200-6671
Mailing Address - Fax:
Practice Address - Street 1:9745 N HWY 16
Practice Address - Street 2:
Practice Address - City:POTEET
Practice Address - State:TX
Practice Address - Zip Code:78065
Practice Address - Country:US
Practice Address - Phone:830-200-6671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX352400164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse