Healthcare Provider Details

I. General information

NPI: 1033790670
Provider Name (Legal Business Name): JOE A ESPINOZA JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WEST 42ND ST STE 3200
SCOTTSBLUFF NE
69361-4669
US

IV. Provider business mailing address

4021 AVENUE B
SCOTTSBLUFF NE
69361-4602
US

V. Phone/Fax

Practice location:
  • Phone: 308-635-3888
  • Fax:
Mailing address:
  • Phone: 308-630-1111
  • Fax: 308-630-1815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberU1267
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number36796
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: