Provider Demographics
NPI:1972113058
Name:TRUJILLO RODRIGUEZ, LORENA (NP)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:TRUJILLO RODRIGUEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18108 S PARKVIEW DR APT I37
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-6687
Mailing Address - Country:US
Mailing Address - Phone:832-513-8801
Mailing Address - Fax:
Practice Address - Street 1:14629 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-7500
Practice Address - Country:US
Practice Address - Phone:281-589-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX795136163W00000X
TX1005953363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse