Provider Demographics
NPI:1467659219
Name:JOHN J. PEREZ, O.D., P.C
Entity Type:Organization
Organization Name:JOHN J. PEREZ, O.D., P.C
Other - Org Name:HOUSTON EYECARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THERAPUETIC OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:713-692-0667
Mailing Address - Street 1:5544 AIRLINE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-4904
Mailing Address - Country:US
Mailing Address - Phone:713-692-0667
Mailing Address - Fax:
Practice Address - Street 1:5544 AIRLINE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-4904
Practice Address - Country:US
Practice Address - Phone:713-692-0667
Practice Address - Fax:713-692-0602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3138TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX093137002Medicaid
TXW27542Medicare UPIN
TX093137002Medicaid