Individual
ESEOSA EGUAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
811 W INTERSTATE 20 UNIT G22, ARLINGTON, TX 76017
(817) 807-9060
(817) 419-4505
Mailing address
811 W INTERSTATE 20 UNIT G22, ARLINGTON, TX 76017-5871
(817) 807-9060
(817) 419-4505
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
P8241
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
349309001
—
TX
Enumeration date
06/08/2012
Last updated
04/15/2019
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