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NPI Code Detail

MEDICARE: MRS. MARY M PERALES LMT

MEDICARE:  MRS. MARY M PERALES  LMT
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
1225700000XMassage TherapistMT030195TX

General Provider Information

NPI Number : 1942375787
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY M PERALES LMT
Provider Business Mailing Address
First Line : 1302 HUNTER DR
Second Line :
City : EL PASO
State : TX
Zip : 79915-1628
Country : US
Telephone Number : 915-217-0571
Fax Number :
Provider Business Practice Location Address
First Line : 7502 BENSON DR
Second Line :
City : EL PASO
State : TX
Zip : 79915-1636
Country : US
Telephone Number : 915-471-9116
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. MARY M PERALES LMT” Practice Location

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