Provider Demographics
NPI:1538916283
Name:ESPINO, JUAN MANUEL (PTA)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:MANUEL
Last Name:ESPINO
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14617 PASAJE PL
Mailing Address - Street 2:
Mailing Address - City:HORIZON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79928-7608
Mailing Address - Country:US
Mailing Address - Phone:915-316-3000
Mailing Address - Fax:
Practice Address - Street 1:2114 N ZARAGOZA RD STE C1
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-8129
Practice Address - Country:US
Practice Address - Phone:915-271-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2181654208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation