Provider Demographics
NPI:1275735680
Name:CRUZ, ISABEL ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:ISABEL
Middle Name:ANN
Last Name:CRUZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 W LITTLE YORK RD
Mailing Address - Street 2:STE E
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-1349
Mailing Address - Country:US
Mailing Address - Phone:713-699-2020
Mailing Address - Fax:713-697-2016
Practice Address - Street 1:415 W LITTLE YORK RD
Practice Address - Street 2:STE E
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-1349
Practice Address - Country:US
Practice Address - Phone:713-699-2020
Practice Address - Fax:713-697-2016
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6278152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F7954Medicare PIN