Provider Demographics
NPI:1356820377
Name:PEREZ, EVA INEZ
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:INEZ
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 BEBEE RD APT 817
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-2031
Mailing Address - Country:US
Mailing Address - Phone:956-212-0021
Mailing Address - Fax:
Practice Address - Street 1:828 BEBEE RD APT 817
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-2031
Practice Address - Country:US
Practice Address - Phone:956-212-0021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX358522355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant