MEDICARE: LAREDO FAMILY MEDICINE P A

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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1265656839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAREDO FAMILY MEDICINE P A

Provider Business Mailing Address
First Line	:	4151 JAIME ZAPATA MEMORIAL HIGHWAY
Second Line	:	SUITE 104
City	:	LAREDO
State	:	TX
Zip	:	78043-4741
Country	:	US
Telephone Number	:	956-728-9888
Fax Number	:	956-728-9879

Provider Business Practice Location Address
First Line	:	4151 JAIME ZAPATA MEMORIAL HIGHWAY
Second Line	:	SUITE 104
City	:	LAREDO
State	:	TX
Zip	:	78043-4741
Country	:	US
Telephone Number	:	956-728-9888
Fax Number	:	956-728-9879

Authorized Official
Title or Position	:	OWNER AND PHYSICIAN
Name	:	OSCAR PEREZ
Credential	:	M.D.
Telephone Number	:	956-728-9888

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	09/12/2011

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Directions to “LAREDO FAMILY MEDICINE P A ” Practice Location

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