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Individual

MR. JEFFREY DELA CRUZ DELA CRUZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6550 FANNIN ST, SUITE 1901, HOUSTON, TX 77030-2717
(713) 441-1100
(713) 790-2643
Mailing address
6550 FANNIN ST, SUITE 1901, HOUSTON, TX 77030-2717
(713) 441-1100
(713) 790-2643

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
001933
GA
207R00000X
Internal Medicine Physician
Primary
N3608
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1407041395
BLUE CROSS BLUE SHIELD
TX
05
206318201
TX
Enumeration date
09/13/2007
Last updated
01/22/2010
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