Provider Demographics
NPI:1588722359
Name:ESGUERRA, ANNIE MARIE CASTILLO (PT, DPT)
Entity type:Individual
Prefix:
First Name:ANNIE MARIE
Middle Name:CASTILLO
Last Name:ESGUERRA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 TESORO BLVD
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-7580
Mailing Address - Country:US
Mailing Address - Phone:956-227-2110
Mailing Address - Fax:956-519-3935
Practice Address - Street 1:7600 W EXPRESSWAY 83
Practice Address - Street 2:SUITE 5
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572
Practice Address - Country:US
Practice Address - Phone:956-581-7171
Practice Address - Fax:956-519-3935
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1088615225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T6208OtherBLUE CROSS BLUE SHIELD
TX286607101Medicaid