Provider Demographics
NPI:1588540207
Name:ESTEBAN, ANA DOMINIQUE CANLAS (MSOT, OTR)
Entity type:Individual
Prefix:
First Name:ANA DOMINIQUE
Middle Name:CANLAS
Last Name:ESTEBAN
Suffix:
Gender:F
Credentials:MSOT, OTR
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:
Other - Last Name:ESTEBAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3721 BALSAM FIR DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-6351
Mailing Address - Country:US
Mailing Address - Phone:972-816-2075
Mailing Address - Fax:
Practice Address - Street 1:2011 BROADWAY ST STE 130
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5945
Practice Address - Country:US
Practice Address - Phone:281-997-8509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122974225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist