Provider Demographics
NPI:1013341007
Name:SAMANIEGO ESTRADA, KARINA BELEN (PHD)
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:BELEN
Last Name:SAMANIEGO ESTRADA
Suffix:
Gender:F
Credentials:PHD
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 631422
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-0020
Mailing Address - Country:US
Mailing Address - Phone:972-505-3086
Mailing Address - Fax:469-472-1933
Practice Address - Street 1:600 E JOHN CARPENTER FWY STE 283
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-4576
Practice Address - Country:US
Practice Address - Phone:469-299-5701
Practice Address - Fax:469-472-1933
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37394103TC0700X, 103TC1900X, 103TC2200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent