MEDICARE: DR. BOBBY PERVEZ MD

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	K1619	TX

General Provider Information

NPI Number	:	1609878461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BOBBY PERVEZ MD

Provider Business Mailing Address
First Line	:	15200 SOUTHWEST FWY
Second Line	:	285
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3845
Country	:	US
Telephone Number	:	281-240-2211
Fax Number	:	281-240-2260

Provider Business Practice Location Address
First Line	:	15200 SOUTHWEST FWY
Second Line	:	285
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3845
Country	:	US
Telephone Number	:	281-240-2211
Fax Number	:	281-240-2260

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	07/08/2007

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