Provider Demographics
NPI:1326583709
Name:PEREZ, ROGELIO JOSE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ROGELIO
Middle Name:JOSE
Last Name:PEREZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4242 WOODCOCK DR STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1325
Mailing Address - Country:US
Mailing Address - Phone:210-481-8673
Mailing Address - Fax:210-314-2480
Practice Address - Street 1:4242 WOODCOCK DR STE 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1325
Practice Address - Country:US
Practice Address - Phone:210-481-8673
Practice Address - Fax:210-314-2480
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-21
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX559281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical