Provider Demographics
NPI:1629378930
Name:PEREZ, CLAUDIA MARIS
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:MARIS
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 W OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS FRESNOS
Mailing Address - State:TX
Mailing Address - Zip Code:78566-3635
Mailing Address - Country:US
Mailing Address - Phone:956-233-4119
Mailing Address - Fax:956-233-4115
Practice Address - Street 1:503 W OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:LOS FRESNOS
Practice Address - State:TX
Practice Address - Zip Code:78566-3635
Practice Address - Country:US
Practice Address - Phone:956-233-4119
Practice Address - Fax:956-233-4115
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105254235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist