Provider Demographics
NPI:1538219233
Name:ESCOBEDO, MICHAEL SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SCOTT
Last Name:ESCOBEDO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2312 WESTERN TRAILS BLVD
Mailing Address - Street 2:#103
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1642
Mailing Address - Country:US
Mailing Address - Phone:512-347-9794
Mailing Address - Fax:512-442-7300
Practice Address - Street 1:2312 WESTERN TRAILS BLVD
Practice Address - Street 2:#103
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1642
Practice Address - Country:US
Practice Address - Phone:512-347-9794
Practice Address - Fax:512-442-7300
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT5327641-1205208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice