Healthcare Provider Details

I. General information

NPI: 1952131047
Provider Name (Legal Business Name): DAVID B. PEREZ RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2024
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4602 N BARTLETT AVE
LAREDO TX
78041-3803
US

IV. Provider business mailing address

4602 N BARTLETT AVE
LAREDO TX
78041-3803
US

V. Phone/Fax

Practice location:
  • Phone: 956-523-7850
  • Fax:
Mailing address:
  • Phone: 956-523-7850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number708279
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: