Provider Demographics
NPI:1992131502
Name:TREJO-MENA, DIANA LAURA (OD)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:LAURA
Last Name:TREJO-MENA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7920 LONG POINT RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-3502
Mailing Address - Country:US
Mailing Address - Phone:832-831-4093
Mailing Address - Fax:
Practice Address - Street 1:7920 LONG POINT RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-3502
Practice Address - Country:US
Practice Address - Phone:832-831-4093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8227-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist