Healthcare Provider Details

I. General information

NPI: 1285690768
Provider Name (Legal Business Name): TESSA V PEREZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 01/09/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 AVENUE E
BILLINGS MT
59102-6561
US

IV. Provider business mailing address

3533 S ALAMEDA ST SUITE 303-JOSEPH SLOAN MEDICAL CENTER
CORPUS CHRISTI TX
78411-1721
US

V. Phone/Fax

Practice location:
  • Phone: 406-281-8700
  • Fax: 406-281-8708
Mailing address:
  • Phone: 361-853-3222
  • Fax: 361-561-2692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL4641
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number100592
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: