Provider Demographics
NPI:1144424920
Name:ESCOBAR, JOSE FERNANDO (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:FERNANDO
Last Name:ESCOBAR
Suffix:
Gender:M
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 4449
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-4449
Mailing Address - Country:US
Mailing Address - Phone:956-362-8570
Mailing Address - Fax:956-362-8575
Practice Address - Street 1:5513 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5563
Practice Address - Country:US
Practice Address - Phone:956-362-8570
Practice Address - Fax:956-362-8572
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5150208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX194031404Medicaid
TX194031403Medicaid
TX526960YKP5Medicare PIN
TXTXB113086Medicare PIN
TX194031404Medicaid
TX194031403Medicaid
TXTXB113013Medicare PIN