MEDICARE: KATALINA PEREZ RN

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	163W00000X	Registered Nurse	915894	TX

General Provider Information

NPI Number	:	1588142111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATALINA PEREZ RN

Provider Business Mailing Address
First Line	:	19422 CYPRESS FLOWER DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-5525
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8922 IRON SPRINGS DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77034-3643
Country	:	US
Telephone Number	:	281-788-0771
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2018
Last Update Date	:	08/06/2018

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