Provider Demographics
NPI:1700829181
Name:PEREZ, TRINIDAD RAMIREZ (LVN)
Entity Type:Individual
Prefix:MRS
First Name:TRINIDAD
Middle Name:RAMIREZ
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77803-4820
Mailing Address - Country:US
Mailing Address - Phone:979-422-2044
Mailing Address - Fax:
Practice Address - Street 1:3501 S TEXAS AVE
Practice Address - Street 2:202
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3749
Practice Address - Country:US
Practice Address - Phone:979-422-2044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX145876164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse