Provider Demographics
NPI:1083356125
Name:PEREIRA, NIGEL ALOYSIUS
Entity Type:Individual
Prefix:
First Name:NIGEL
Middle Name:ALOYSIUS
Last Name:PEREIRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 HORSESHOE LN
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-5650
Mailing Address - Country:US
Mailing Address - Phone:903-234-0000
Mailing Address - Fax:
Practice Address - Street 1:2201 HORSESHOE LN
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5650
Practice Address - Country:US
Practice Address - Phone:903-234-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-09
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant