Provider Demographics
NPI:1962247312
Name:ESCOBAR, NANCI N (MA)
Entity type:Individual
Prefix:
First Name:NANCI
Middle Name:N
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:NANCI
Other - Middle Name:NOEMI
Other - Last Name:ESCOBAR -VEGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:804 BRIDLE DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-6020
Mailing Address - Country:US
Mailing Address - Phone:972-762-2297
Mailing Address - Fax:
Practice Address - Street 1:804 BRIDLE DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-6020
Practice Address - Country:US
Practice Address - Phone:972-762-2297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant