Healthcare Provider Details

I. General information

NPI: 1992695399
Provider Name (Legal Business Name): FABIAN ESCOBAR PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4717 HONDO PASS DR
EL PASO TX
79904-1474
US

IV. Provider business mailing address

4717 HONDO PASS DR
EL PASO TX
79904-1474
US

V. Phone/Fax

Practice location:
  • Phone: 915-975-7028
  • Fax: 915-292-7561
Mailing address:
  • Phone: 915-975-7028
  • Fax: 915-292-7561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number939345
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: