Provider Demographics
NPI:1427689454
Name:ESQUIVEL, ERICA
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:
Last Name:ESQUIVEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 N MAJOR DR APT 815
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-4077
Mailing Address - Country:US
Mailing Address - Phone:903-969-0452
Mailing Address - Fax:
Practice Address - Street 1:87 I 10 N
Practice Address - Street 2:SUITE 225
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707
Practice Address - Country:US
Practice Address - Phone:409-835-0228
Practice Address - Fax:409-835-0151
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215897224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant