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NPI Code Detail

MEDICARE: MRS. SUE ELLEN PEREZ PA-C

MEDICARE: MRS. SUE ELLEN PEREZ PA-C
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
1207K00000XAllergy & Immunology PhysicianC5-0000337DE
2363A00000XPhysician AssistantMA052372PA
3363A00000XPhysician AssistantPA12152TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629095559
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUE ELLEN PEREZ PA-C
Provider Business Mailing Address
First Line : 6560 FANNIN ST STE 2100
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2769
Country : US
Telephone Number : 713-486-9800
Fax Number :
Provider Business Practice Location Address
First Line : 6560 FANNIN ST STE 2100
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2769
Country : US
Telephone Number : 713-486-9800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2006
Last Update Date : 01/31/2025

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Directions to “ MRS. SUE ELLEN PEREZ PA-C” Practice Location

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