Provider Demographics
NPI:1558796417
Name:PEREZ, CRYSTAL VERONICA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:VERONICA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 S BRIDGE AVE
Mailing Address - Street 2:330 N. OHIO MERCEDES, TEXAS 78570
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-7129
Mailing Address - Country:US
Mailing Address - Phone:956-447-8600
Mailing Address - Fax:
Practice Address - Street 1:906 S BRIDGE AVE
Practice Address - Street 2:330 N. OHIO MERCEDES, TEXAS 78570
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-7129
Practice Address - Country:US
Practice Address - Phone:956-447-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX765964363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily