Doctor Name: | TIMOTHY W. PEREZ |
NPI Number: | 1093729006 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D |
License Number: | 93-126 |
Business Practice Address: | 715 Dr Martin Luther King Ne Ste 301 Albuquerque, NM - 871022534 |
Business Phone Number: | 5057277090 |
Business Fax Number: | 5057277099 |
Mailing Address: | 715 Dr Martin Luther King Ne, Ste 301 ALBUQUERQUE |
State: | NM |
Postal Code: | 871022534 |
Phone Number: | 5057277090 |
Fax Number: | 5057277099 |
NPI Enumeration Date: | 07/27/2006 |
NPI Last Update Date: | 02/16/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 93-126 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NM |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |