Healthcare Provider Details

I. General information

NPI: 1821079807
Provider Name (Legal Business Name): MICHAEL ESQUIVEL PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 TRAWOOD DR STE C
EL PASO TX
79935-3042
US

IV. Provider business mailing address

2260 TRAWOOD DR STE C
EL PASO TX
79935-3042
US

V. Phone/Fax

Practice location:
  • Phone: 915-591-4632
  • Fax: 915-591-4069
Mailing address:
  • Phone: 915-591-4632
  • Fax: 915-591-4069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA00398
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: