Healthcare Provider Details

I. General information

NPI: 1861112732
Provider Name (Legal Business Name): BLANCA ESTELA ESCOBAR M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 MICKEY GILLEY BLVD
PASADENA TX
77505-3005
US

IV. Provider business mailing address

3920 MICKEY GILLEY BLVD
PASADENA TX
77505-3005
US

V. Phone/Fax

Practice location:
  • Phone: 713-740-0608
  • Fax:
Mailing address:
  • Phone: 713-740-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number102878
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: