Provider Demographics
NPI:1881724664
Name:ESPANA, PABLO (DC DABCO)
Entity type:Individual
Prefix:
First Name:PABLO
Middle Name:
Last Name:ESPANA
Suffix:
Gender:M
Credentials:DC DABCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5226
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-9226
Mailing Address - Country:US
Mailing Address - Phone:214-942-4015
Mailing Address - Fax:214-942-4980
Practice Address - Street 1:1107 W JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-5145
Practice Address - Country:US
Practice Address - Phone:214-942-4015
Practice Address - Fax:214-942-4980
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC4185111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB0081205OtherBCBS UPIN
TXDC4185OtherCHIROPRACTOR
TX8AD500OtherBCBS
TXB0081205OtherBCBS UPIN