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General NPI Number Information
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NPI Number | 1669558649
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Entity Type | Individual
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Provider Name | CORNELIA C TREJO D. D. S.
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Gender | Female
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2600 S GESSNER RD SUITE 304
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City | HOUSTON
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State | TX
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Zip | 77063-3200
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Country | US
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Telephone | 713-785-9599
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Fax | 713-785-1191
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Provider Business Mailing Address
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Address Line | 2603 C WEST LANE
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City | HOUSTON
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State | TX
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Zip | 77027-4944
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Country | US
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Telephone | 713-622-5139
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 17954
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License Number State | TX
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