Provider Demographics
NPI:1629943386
Name:PEREZ, BLANCA JOSEFINA
Entity type:Individual
Prefix:
First Name:BLANCA
Middle Name:JOSEFINA
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 1:6544 GREATWOOD PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6808
Mailing Address - Country:US
Mailing Address - Phone:832-277-0500
Mailing Address - Fax:
Practice Address - Street 1:6544 GREATWOOD PKWY STE A
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-6808
Practice Address - Country:US
Practice Address - Phone:832-277-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-10
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25-398246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant