Provider Demographics
NPI:1245379601
Name:JANET L. PEREZ FNP-BC INC.
Entity Type:Organization
Organization Name:JANET L. PEREZ FNP-BC INC.
Other - Org Name:FAMILY MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:361-225-2271
Mailing Address - Street 1:4833 S STAPLES ST
Mailing Address - Street 2:STE. 1
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-2609
Mailing Address - Country:US
Mailing Address - Phone:361-225-2271
Mailing Address - Fax:361-225-2273
Practice Address - Street 1:4833 S STAPLES ST
Practice Address - Street 2:STE. 1
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-2609
Practice Address - Country:US
Practice Address - Phone:361-225-2271
Practice Address - Fax:361-225-2273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX606848261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ14696Medicare UPIN
TX00618WMedicare ID - Type Unspecified