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General NPI Number Information
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NPI Number | 1639363997
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Entity Type | Organization
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Legal Business Name | CRISTINA DE LA PENA, O.D., P.A.
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 10850 LOUETTA ROAD SUITE 1000
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City | HOUSTON
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State | TX
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Zip | 77070-3538
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Country | US
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Telephone | 281-370-3030
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Fax |
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Provider Business Mailing Address
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Address Line | 10850 LOUETTA ROAD SUITE 1000
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City | HOUSTON
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State | TX
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Zip | 77070-3538
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Country | US
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Telephone | 281-370-3030
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CRISTINA ISABEL DE LA PENA
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Credential | O.D.
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Telephone | 281-370-3030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 6209TG
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License Number State | TX
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