Healthcare Provider Details

I. General information

NPI: 1558175695
Provider Name (Legal Business Name): DESIREE SAMANTHA ESCOBAR FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 E PAISANO DR
EL PASO TX
79905-3913
US

IV. Provider business mailing address

5100 E PAISANO DR
EL PASO TX
79905-3913
US

V. Phone/Fax

Practice location:
  • Phone: 915-774-2550
  • Fax: 915-774-2551
Mailing address:
  • Phone: 915-774-2550
  • Fax: 915-774-2551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1190035
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: