Healthcare Provider Details

I. General information

NPI: 1740546571
Provider Name (Legal Business Name): LUIS ARMANDO ESPINOZA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2012
Last Update Date: 04/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MAGUEY CT
SUNLAND PARK NM
88063-9513
US

IV. Provider business mailing address

7174 ROYAL PALM ST
EL PASO TX
79912-7255
US

V. Phone/Fax

Practice location:
  • Phone: 575-589-2400
  • Fax:
Mailing address:
  • Phone: 915-474-5293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: