Provider Demographics
NPI:1275805798
Name:PEREZ, SERGIO XAVIER JR (CSA)
Entity Type:Individual
Prefix:MR
First Name:SERGIO
Middle Name:XAVIER
Last Name:PEREZ
Suffix:JR
Gender:M
Credentials:CSA
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Mailing Address - Street 1:3827 RELAMPAGO
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-4081
Mailing Address - Country:US
Mailing Address - Phone:210-373-2892
Mailing Address - Fax:
Practice Address - Street 1:3827 RELAMPAGO
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-4081
Practice Address - Country:US
Practice Address - Phone:210-373-2892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty