Provider Demographics
NPI:1518157791
Name:PEREZ, EDUARDO (LBSW)
Entity Type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3203 S MONTEVIDEO AVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6619
Mailing Address - Country:US
Mailing Address - Phone:956-381-0103
Mailing Address - Fax:956-287-1560
Practice Address - Street 1:3203 S MONTEVIDEO AVE
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-6619
Practice Address - Country:US
Practice Address - Phone:956-381-0103
Practice Address - Fax:956-287-1560
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX08464104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker