MEDICARE: DANIEL PERALES CCP

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	242T00000X	Perfusionist	PF1098	TX

General Provider Information

NPI Number	:	1891168860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL PERALES CCP

Provider Business Mailing Address
First Line	:	14603 HUEBNER RD BLDG 28
Second Line	:	STE. 28101
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-5497
Country	:	US
Telephone Number	:	210-614-7074
Fax Number	:	210-614-7091

Provider Business Practice Location Address
First Line	:	14603 HUEBNER RD BLDG 28
Second Line	:	STE. 28101
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-5497
Country	:	US
Telephone Number	:	210-614-7074
Fax Number	:	210-614-7091

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

Provider Enumeration Date	:	11/12/2015
Last Update Date	:	09/09/2025

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Directions to “ DANIEL PERALES CCP” Practice Location

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