Provider Demographics
NPI:1508539693
Name:FRANCISCO JOSE PEREZ MATA PLLC
Entity Type:Organization
Organization Name:FRANCISCO JOSE PEREZ MATA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:PEREZ MATA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-930-0066
Mailing Address - Street 1:720 S 320TH ST STE F
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5254
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:720 S 320TH ST STE F
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5254
Practice Address - Country:US
Practice Address - Phone:917-930-0066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty