Healthcare Provider Details

I. General information

NPI: 1033027594
Provider Name (Legal Business Name): DEMETREONTA ESTES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21201 EMERALD MIST PKWY APT 1426
SPRING TX
77379-1549
US

IV. Provider business mailing address

21201 EMERALD MIST PKWY APT 1426
SPRING TX
77379-1549
US

V. Phone/Fax

Practice location:
  • Phone: 281-451-8734
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number96617
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: