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General NPI Number Information
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NPI Number | 1720061484
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Entity Type | Organization
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Legal Business Name | MANUEL PEREZ
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Dates
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Enumeration Date | 11/26/2005
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Last Update Date | 01/10/2011
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Provider Practice Location Address
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Address Line | 1010 DECKER DR
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City | BAYTOWN
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State | TX
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Zip | 77520-4435
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Country | US
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Telephone | 281-422-6191
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Fax | 281-422-2661
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Provider Business Mailing Address
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Address Line | 1010 DECKER DR
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City | BAYTOWN
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State | TX
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Zip | 77520-4435
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Country | US
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Telephone | 281-422-6191
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Fax | 281-422-2661
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MANUEL PEREZ
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Credential | RRT
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Telephone | 281-422-6191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0032958
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License Number State | TX
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