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General NPI Number Information
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NPI Number | 1851245328
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Entity Type | Organization
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Legal Business Name | BIOSPAN PHYSICAL THERAPY & LONGEVITY LLC
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Dates
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Enumeration Date | 02/23/2026
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Last Update Date | 02/23/2026
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Provider Practice Location Address
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Address Line | 5555 N MESA ST STE 400
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City | EL PASO
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State | TX
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Zip | 79912-5424
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Country | US
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Telephone | 915-233-7774
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Fax | 915-219-9022
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Provider Business Mailing Address
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Address Line | 1605 GEORGE DIETER DR STE 636
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City | EL PASO
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State | TX
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Zip | 79936-5600
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Country | US
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Telephone | 915-671-1371
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Fax | 915-219-9022
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Authorized Official
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Title or Position | OWNER
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Name | PABLO EDUARDO ESTRADA
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Credential | DPT, OCS
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Telephone | 915-233-7774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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