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NPI Code Detail

MEDICARE: ROGER PERALES APRN

MEDICARE: ROGER PERALES APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner1019143TX

General Provider Information

NPI Number : 1235955931
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROGER PERALES APRN
Provider Business Mailing Address
First Line : 6720 AIMPOINT DR
Second Line :
City : PLANO
State : TX
Zip : 75023-1850
Country : US
Telephone Number : 214-552-2516
Fax Number :
Provider Business Practice Location Address
First Line : 304 ADMINISTRATION DR
Second Line :
City : DENTON
State : TX
Zip : 76209-2098
Country : US
Telephone Number : 214-552-2516
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2024
Last Update Date : 11/26/2024

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Directions to “ ROGER PERALES APRN” Practice Location

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