MEDICARE: CARMEN JOSEFA PEREZ MD

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	207R00000X	Internal Medicine Physician	J7626	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811950140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEN JOSEFA PEREZ MD

Provider Business Mailing Address
First Line	:	22710 PROFESSIONAL DR
Second Line	:	SUITE 203
City	:	KINGWOOD
State	:	TX
Zip	:	77339-6008
Country	:	US
Telephone Number	:	281-312-8531
Fax Number	:	281-312-8532

Provider Business Practice Location Address
First Line	:	22710 PROFESSIONAL DR
Second Line	:	SUITE 203
City	:	KINGWOOD
State	:	TX
Zip	:	77339-6008
Country	:	US
Telephone Number	:	281-312-8531
Fax Number	:	281-312-8532

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

Provider Enumeration Date	:	04/08/2006
Last Update Date	:	12/31/2009

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Directions to “ CARMEN JOSEFA PEREZ MD” Practice Location

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