Provider Demographics
NPI:1235351404
Name:ELIZABETH I. PEREZ & ASSOCIATES, INC.
Entity Type:Organization
Organization Name:ELIZABETH I. PEREZ & ASSOCIATES, INC.
Other - Org Name:VS MORALES PERSONAL CARE HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ISABEL
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-351-1212
Mailing Address - Street 1:3120 WEST NORTHWEST HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75220-5943
Mailing Address - Country:US
Mailing Address - Phone:214-351-1212
Mailing Address - Fax:214-350-8760
Practice Address - Street 1:9508 CIRCLEWOOD DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-8601
Practice Address - Country:US
Practice Address - Phone:214-351-1212
Practice Address - Fax:214-350-8760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116423310400000X
310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000672300Medicaid