Healthcare Provider Details

I. General information

NPI: 1124402268
Provider Name (Legal Business Name): ROCIO TRUJILLO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2015
Last Update Date: 06/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6812 HARRISBURG BLVD
HOUSTON TX
77011-4626
US

IV. Provider business mailing address

122 W JOHN CARPENTER FWY STE 420
IRVING TX
75039-2014
US

V. Phone/Fax

Practice location:
  • Phone: 713-715-4460
  • Fax:
Mailing address:
  • Phone: 972-957-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number33599
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR9300
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: