MEDICARE: LETICIA F. PEREZOUS, DDS, MS, P.A.

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1952239626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LETICIA F. PEREZOUS, DDS, MS, P.A.

Provider Business Mailing Address
First Line	:	7676 WOODWAY DR STE 310
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-1523
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7676 WOODWAY DR STE 310
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-1523
Country	:	US
Telephone Number	:	713-781-4100
Fax Number	:

Authorized Official
Title or Position	:	MANAGER OF CREDENTIALING
Name	:	CHRISTY DUPIN
Credential	:
Telephone Number	:	480-674-4151

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

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