Provider Demographics
NPI:1265675268
Name:PEREZ, ELIZA (OTR)
Entity Type:Individual
Prefix:
First Name:ELIZA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 W ALBERTA RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-3118
Mailing Address - Country:US
Mailing Address - Phone:956-972-0600
Mailing Address - Fax:956-972-0604
Practice Address - Street 1:3031 W ALBERTA RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3118
Practice Address - Country:US
Practice Address - Phone:956-972-0600
Practice Address - Fax:956-972-0604
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110425225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist