Basic Information
| Provider Information | |||||||||
| NPI: | 1245235647 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ESPARZA | ||||||||
| FirstName: | RAMON | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6210 E HWY 290 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787231142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124839596 | ||||||||
| FaxNumber: | 5124066216 | ||||||||
| Practice Location | |||||||||
| Address1: | 15803 WINDERMERE DR STE 103 | ||||||||
| Address2: | |||||||||
| City: | PFLUGERVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786602482 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5129892680 | ||||||||
| FaxNumber: | 5124066216 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2005 | ||||||||
| LastUpdateDate: | 01/26/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | L2238 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 143942405 | 05 | TX | MEDICAID | 8B1332 | 01 | TX | MEDICARE | OTHER | 143942406 | 05 | TX | MEDICAID | 163445301 | 05 | TX | MEDICAID |