Provider Demographics
NPI:1306047428
Name:ESCOBAR, CAROLINA (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLINA
Middle Name:
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:MD
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 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:3410 WORTH ST STE 300
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2012
Practice Address - Country:US
Practice Address - Phone:214-370-1000
Practice Address - Fax:214-370-1585
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXP0204207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX306873602Medicaid
TXP01213247OtherRAILROAD MEDICARE
LA09286Medicaid
LA09286Medicaid
TX318696YKYCMedicare PIN
TX306873602Medicaid