MEDICARE: FABIAN ESCOBAR PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	939345	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	327940	AZ

General Provider Information

NPI Number	:	1992695399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FABIAN ESCOBAR PMHNP-BC

Provider Business Mailing Address
First Line	:	4717 HONDO PASS DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79904-1474
Country	:	US
Telephone Number	:	915-975-7028
Fax Number	:	915-292-7561

Provider Business Practice Location Address
First Line	:	4717 HONDO PASS DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79904-1474
Country	:	US
Telephone Number	:	915-975-7028
Fax Number	:	915-292-7561

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2025
Last Update Date	:	03/04/2026

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