Healthcare Provider Details

I. General information

NPI: 1467395459
Provider Name (Legal Business Name): KIRAN ESPARZA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5748 N MESA ST
EL PASO TX
79912-5427
US

IV. Provider business mailing address

921 CORTIJO DR
EL PASO TX
79912-2503
US

V. Phone/Fax

Practice location:
  • Phone: 915-224-2443
  • Fax:
Mailing address:
  • Phone: 915-316-9499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number126396
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: