Provider Demographics
NPI:1679782072
Name:PEREZ, MARIA CECILIA (LAT)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:CECILIA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14515 KEMROCK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77049-4209
Mailing Address - Country:US
Mailing Address - Phone:713-400-0390
Mailing Address - Fax:281-991-2450
Practice Address - Street 1:4410 CRENSHAW RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-3629
Practice Address - Country:US
Practice Address - Phone:713-740-0390
Practice Address - Fax:281-991-2450
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT32392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer