Provider Demographics
NPI:1629746094
Name:PERAZA-URRUTIA DDS PLLC
Entity Type:Organization
Organization Name:PERAZA-URRUTIA DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PERAZA-URRUTIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-725-2598
Mailing Address - Street 1:28002 HUNTER CREST LN
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-1960
Mailing Address - Country:US
Mailing Address - Phone:281-725-2598
Mailing Address - Fax:
Practice Address - Street 1:4603 HIGHWAY 6 N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-2821
Practice Address - Country:US
Practice Address - Phone:832-427-1998
Practice Address - Fax:832-427-1885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty