Healthcare Provider Details

I. General information

NPI: 1770815573
Provider Name (Legal Business Name): ELIZABETH PEREZ, OD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2010
Last Update Date: 12/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E HOUSTON ST
BEEVILLE TX
78102-5023
US

IV. Provider business mailing address

701 E HOUSTON ST
BEEVILLE TX
78102-5023
US

V. Phone/Fax

Practice location:
  • Phone: 361-362-2020
  • Fax: 361-362-2030
Mailing address:
  • Phone: 361-362-2020
  • Fax: 361-362-2030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number6662T
License Number StateTX

VIII. Authorized Official

Name: DR. ELIZABETH PEREZ
Title or Position: OWNER
Credential: O.D.
Phone: 361-387-5300