Healthcare Provider Details

I. General information

NPI: 1588539688
Provider Name (Legal Business Name): EVA RUTH ESCOBAR LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 GEORGE DIETER DR STE 100
EL PASO TX
79936-5686
US

IV. Provider business mailing address

3022 WEDGEWOOD DR
EL PASO TX
79925-4303
US

V. Phone/Fax

Practice location:
  • Phone: 915-590-1326
  • Fax:
Mailing address:
  • Phone: 915-526-4979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number308667
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: