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Individual

ELSA ESCOBEDO-LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.T.R,

Contact information

Practice address
12732 OLD SPANISH TRL, LIVE OAK, TX 78233-2526
(210) 857-0317
Mailing address
12732 OLD SPANISH TRL, LIVE OAK, TX 78233-2526
(210) 857-0317

Taxonomy

Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
102700
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
825T90
BLUE CROSS BLUE SHEILD
TX
Enumeration date
02/26/2009
Last updated
12/01/2011
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