Provider Demographics
NPI:1619381241
Name:PENA DE RODRIGUEZ, ANA M
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:M
Last Name:PENA DE RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ANA
Other - Middle Name:MILENA
Other - Last Name:PENA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2420 GESSNER RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-5013
Mailing Address - Country:US
Mailing Address - Phone:713-468-9130
Mailing Address - Fax:713-468-9820
Practice Address - Street 1:2420 GESSNER RD
Practice Address - Street 2:SUITE C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-5013
Practice Address - Country:US
Practice Address - Phone:713-468-9130
Practice Address - Fax:713-468-9820
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXABO 187580156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician