Individual
DR. PABLO EDUARDO ESTRADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, OCS
Contact information
Practice address
3220 MONTANA AVE, EL PASO, TX 79903-2630
(915) 444-8116
Mailing address
3220 MONTANA AVE, EL PASO, TX 79903-2630
(915) 444-8116
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
1271229
TX
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
Primary
1271229
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1271229
LICENSE
TX
01
—
52596
BOARD SPECIALTY CERTIFICATE
—
Enumeration date
11/01/2018
Last updated
01/06/2020
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