Provider Demographics
NPI:1447461462
Name:ESCOBAR, JORGE JAVIER JR (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:JAVIER
Last Name:ESCOBAR
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:640 E BRAVO BLVD
Mailing Address - Street 2:
Mailing Address - City:ROMA
Mailing Address - State:TX
Mailing Address - Zip Code:78584-5720
Mailing Address - Country:US
Mailing Address - Phone:956-849-2176
Mailing Address - Fax:956-849-2176
Practice Address - Street 1:640 E BRAVO BLVD
Practice Address - Street 2:
Practice Address - City:ROMA
Practice Address - State:TX
Practice Address - Zip Code:78584-5720
Practice Address - Country:US
Practice Address - Phone:956-849-2176
Practice Address - Fax:956-849-3439
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5042207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine