Provider Demographics
NPI:1275600322
Name:PEREZ, JOSE A (ABO)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:A
Last Name:PEREZ
Suffix:
Gender:M
Credentials:ABO
Other - Prefix:
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Mailing Address - Street 1:1919 NORTH LOOP W
Mailing Address - Street 2:SUITE 170A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1374
Mailing Address - Country:US
Mailing Address - Phone:713-802-2020
Mailing Address - Fax:713-802-2022
Practice Address - Street 1:1919 NORTH LOOP W
Practice Address - Street 2:SUITE 170A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1374
Practice Address - Country:US
Practice Address - Phone:713-802-2020
Practice Address - Fax:713-802-2022
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXDR4076156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1225260001Medicare ID - Type UnspecifiedPRESCRIPTION LENS & FRAME