Provider Demographics
NPI:1609227107
Name:VICTORIA C. PEREZ, O.D., PLLC
Entity Type:Organization
Organization Name:VICTORIA C. PEREZ, O.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER AND SOLE MEMBER / PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:CATHLEEN
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:361-562-6036
Mailing Address - Street 1:999 COUNTY ROAD 116
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-9357
Mailing Address - Country:US
Mailing Address - Phone:361-562-6036
Mailing Address - Fax:
Practice Address - Street 1:62 N CAMERON ST
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-4953
Practice Address - Country:US
Practice Address - Phone:361-664-3571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-26
Last Update Date:2016-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8886152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty