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General NPI Number Information
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NPI Number | 1891327110
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Entity Type | Individual
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Provider Name | GISELLE MYRELIS SANTANA PEREZ DC
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Gender | Female
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Dates
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Enumeration Date | 02/05/2020
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 1220 N TOWN EAST BLVD STE 250
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City | MESQUITE
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State | TX
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Zip | 75150-4682
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Country | US
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Telephone | 972-279-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 RIO GRANDE DR APT 1111
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City | PLANO
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State | TX
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Zip | 75075-6742
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Country | US
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Telephone | 404-360-7560
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIR010295
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 14900
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License Number State | TX
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