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General NPI Number Information
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NPI Number | 1306302013
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Entity Type | Individual
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Provider Name | ANYSSA RENEE PEREZ
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Gender | Female
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Dates
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Enumeration Date | 02/18/2019
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Last Update Date | 04/24/2019
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Provider Practice Location Address
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Address Line | 416 LINDBERG AVE STE A
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City | MCALLEN
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State | TX
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Zip | 78501-2922
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Country | US
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Telephone | 956-630-4161
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Fax | 956-664-1398
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Provider Business Mailing Address
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Address Line | PO BOX 3046
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City | MALVERN
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State | PA
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Zip | 19355-0746
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Country | US
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Telephone | 956-630-4161
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Fax | 956-664-1398
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA12742
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License Number State | TX
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