Provider Demographics
NPI:1609372911
Name:ESPARZA, VINCENT
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:ESPARZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 DAVIS LN STE 106
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-3802
Mailing Address - Country:US
Mailing Address - Phone:512-494-4020
Mailing Address - Fax:512-494-4022
Practice Address - Street 1:5000 DAVIS LN STE 106
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-3802
Practice Address - Country:US
Practice Address - Phone:512-494-4020
Practice Address - Fax:512-494-4022
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS3658207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine