Provider Demographics
NPI:1497851620
Name:VIOLA PEREZ PC
Entity Type:Organization
Organization Name:VIOLA PEREZ PC
Other - Org Name:COMPREHENSIVE PT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VIOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-712-7021
Mailing Address - Street 1:3054 S MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-5231
Mailing Address - Country:US
Mailing Address - Phone:918-712-7021
Mailing Address - Fax:918-712-9326
Practice Address - Street 1:5930 E 31ST ST
Practice Address - Street 2:SUITE 500
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-5107
Practice Address - Country:US
Practice Address - Phone:918-712-7021
Practice Address - Fax:918-712-9326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1279225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100634320 BMedicaid
OK100634320 AMedicaid
OK100745730AMedicaid