Provider Demographics
NPI:1396482907
Name:CASTANEDA, ELIANA I (OT)
Entity type:Individual
Prefix:
First Name:ELIANA
Middle Name:I
Last Name:CASTANEDA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10610 INWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-2329
Mailing Address - Country:US
Mailing Address - Phone:713-826-6763
Mailing Address - Fax:
Practice Address - Street 1:4557 S WESTERN ST STE B4
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-8044
Practice Address - Country:US
Practice Address - Phone:833-233-7875
Practice Address - Fax:801-206-3059
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104369225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist