Provider Demographics
NPI:1235804733
Name:TRUJILLO, ELIZABETH MARIA (OD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MARIA
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8501 BOB WHITE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-7405
Mailing Address - Country:US
Mailing Address - Phone:832-613-7243
Mailing Address - Fax:
Practice Address - Street 1:12140 EAST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-1918
Practice Address - Country:US
Practice Address - Phone:832-995-2613
Practice Address - Fax:713-330-8543
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10340T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist