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General NPI Number Information
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NPI Number | 1104008598
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Entity Type | Organization
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Legal Business Name | NICHOLAS PEREIRA MDPA
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Dates
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Enumeration Date | 11/28/2007
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 5111 N 10TH ST # 112
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City | MCALLEN
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State | TX
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Zip | 78504-2835
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Country | US
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Telephone | 956-451-2316
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Fax | 956-631-6717
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Provider Business Mailing Address
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Address Line | 5111 N 10TH ST # 112
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City | MCALLEN
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State | TX
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Zip | 78504-2835
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Country | US
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Telephone | 956-451-2316
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Fax | 956-631-6717
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NICHOLAS PEREIRA
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Credential | MD
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Telephone | 956-451-2316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | K3389
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License Number State | TX
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