Provider Demographics
NPI:1639516222
Name:PEREZ, JENNIFER ARLENE (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ARLENE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ARLENE
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1000 N MESA ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4008
Mailing Address - Country:US
Mailing Address - Phone:915-533-1960
Mailing Address - Fax:915-533-2960
Practice Address - Street 1:1000 N MESA ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4008
Practice Address - Country:US
Practice Address - Phone:915-533-1960
Practice Address - Fax:915-533-2960
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXR3178207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program