Provider Demographics
NPI:1982403705
Name:CALDERON, ELIA (OD)
Entity type:Individual
Prefix:DR
First Name:ELIA
Middle Name:
Last Name:CALDERON
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15910 WALNUT SHORES DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-1212
Mailing Address - Country:US
Mailing Address - Phone:832-545-2547
Mailing Address - Fax:
Practice Address - Street 1:18700 W LAKE HOUSTON PKWY STE B101
Practice Address - Street 2:
Practice Address - City:ATASCOCITA
Practice Address - State:TX
Practice Address - Zip Code:77346-3431
Practice Address - Country:US
Practice Address - Phone:832-551-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10815T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist