Provider Demographics
NPI:1083924898
Name:PEREZ, ANDRES A (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:A
Last Name:PEREZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 DUNWICK LN
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77502-4527
Mailing Address - Country:US
Mailing Address - Phone:832-606-2547
Mailing Address - Fax:
Practice Address - Street 1:1124 N VELASCO ST STE E
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-3161
Practice Address - Country:US
Practice Address - Phone:979-849-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11535111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor