Provider Demographics
NPI:1245736859
Name:DELEIJA-LUJANO, JUAN DE DIOS
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:DE DIOS
Last Name:DELEIJA-LUJANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 CAMBRIDGE
Mailing Address - Street 2:SUITE A10.202, MAIL STOP: BCM 903
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-798-5588
Mailing Address - Fax:
Practice Address - Street 1:7200 CAMBRIDGE
Practice Address - Street 2:SUITE A10.202, MAIL STOP: BCM 903
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-798-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program