Healthcare Provider Details

I. General information

NPI: 1275198848
Provider Name (Legal Business Name): LOUIS PEREZ PA-C, MPAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: LOUIS PEREZ

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BREWSTER BLVD
CAMP LEJEUNE NC
28547-2575
US

IV. Provider business mailing address

100 BREWSTER BLVD
CAMP LEJEUNE NC
28547-2575
US

V. Phone/Fax

Practice location:
  • Phone: 910-451-7820
  • Fax:
Mailing address:
  • Phone: 956-536-9598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: