MEDICARE: MARGARITA DOMINGUES DE PEROZO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	1144577	TX

General Provider Information

NPI Number	:	1457122939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARITA DOMINGUES DE PEROZO

Provider Business Mailing Address
First Line	:	1660 KATY GAP RD APT 10105
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-7709
Country	:	US
Telephone Number	:	713-894-5308
Fax Number	:	281-819-6616

Provider Business Practice Location Address
First Line	:	25600 WESTHEIMER PKWY STE 430
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-7293
Country	:	US
Telephone Number	:	281-819-6663
Fax Number	:	281-819-6616

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2024
Last Update Date	:	01/12/2024

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Directions to “ MARGARITA DOMINGUES DE PEROZO ” Practice Location

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