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General NPI Number Information
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NPI Number | 1023504461
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Entity Type | Organization
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Legal Business Name | ROBERTO T. PEREZ SURGICAL ASSISTANT SERVICES
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Dates
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Enumeration Date | 07/09/2018
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Last Update Date | 07/09/2018
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Provider Practice Location Address
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Address Line | 6023 WAMPUM ST
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City | SAN ANTONIO
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State | TX
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Zip | 78238-3456
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Country | US
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Telephone | 210-269-0940
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Fax |
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Provider Business Mailing Address
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Address Line | 6023 WAMPUM ST
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City | SAN ANTONIO
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State | TX
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Zip | 78238-3456
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Country | US
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Telephone | 210-269-0940
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Fax |
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Authorized Official
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Title or Position | CSFA
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Name | MR. ROBERTO T. PEREZ
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Credential | CSFA
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Telephone | 210-269-0940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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