Doctor Name: | ALISSA J PEREZ |
NPI Number: | 1861548778 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A.C |
License Number: | 001309 |
Business Practice Address: | 310 W Alameda St Iowa Park, TX - 763671600 |
Business Phone Number: | 9405924141 |
Business Fax Number: | |
Mailing Address: | 310 W Alameda St, IOWA PARK |
State: | TX |
Postal Code: | 763671600 |
Phone Number: | 9405924141 |
Fax Number: | |
NPI Enumeration Date: | 01/25/2007 |
NPI Last Update Date: | 01/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 001309 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |