MEDICARE: ANDREW TRUJILLO LMSW

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	101YM0800X	Mental Health Counselor	55681	TX

General Provider Information

NPI Number	:	1851831564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW TRUJILLO LMSW

Provider Business Mailing Address
First Line	:	2230 S PINEY POINT RD
Second Line	:	APT 227
City	:	HOUSTON
State	:	TX
Zip	:	77063-1442
Country	:	US
Telephone Number	:	832-570-3137
Fax Number	:

Provider Business Practice Location Address
First Line	:	2230 S PINEY POINT RD
Second Line	:	APT 227
City	:	HOUSTON
State	:	TX
Zip	:	77063-1442
Country	:	US
Telephone Number	:	832-570-3137
Fax Number	:

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

Provider Enumeration Date	:	02/28/2017
Last Update Date	:	02/28/2017

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