Provider Demographics
NPI:1093426561
Name:PEREZ-CASTILLO, JORGE A (SA-C)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:A
Last Name:PEREZ-CASTILLO
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3536 HIGHWAY 6 # 150
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4401
Mailing Address - Country:US
Mailing Address - Phone:832-277-0500
Mailing Address - Fax:
Practice Address - Street 1:3536 HIGHWAY 6 # 150
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4401
Practice Address - Country:US
Practice Address - Phone:832-277-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant