Provider Demographics
NPI:1679185037
Name:PENALOZA ARTEAGA, LUCERO CHRISTIAN (OD)
Entity Type:Individual
Prefix:
First Name:LUCERO
Middle Name:CHRISTIAN
Last Name:PENALOZA ARTEAGA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:LUCERO
Other - Middle Name:CHRISTIAN
Other - Last Name:PENALOZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-4997
Mailing Address - Fax:
Practice Address - Street 1:190 HEIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-3729
Practice Address - Country:US
Practice Address - Phone:713-527-8480
Practice Address - Fax:713-865-5471
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10042TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist