MEDICARE: DR. ISABEL ANN CRUZ OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	6278	TX

General Provider Information

NPI Number	:	1275735680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ISABEL ANN CRUZ OD

Provider Business Mailing Address
First Line	:	415 W LITTLE YORK RD
Second Line	:	STE E
City	:	HOUSTON
State	:	TX
Zip	:	77076-1349
Country	:	US
Telephone Number	:	713-699-2020
Fax Number	:	713-697-2016

Provider Business Practice Location Address
First Line	:	415 W LITTLE YORK RD
Second Line	:	STE E
City	:	HOUSTON
State	:	TX
Zip	:	77076-1349
Country	:	US
Telephone Number	:	713-699-2020
Fax Number	:	713-697-2016

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	11/20/2008

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