Provider Demographics
NPI:1710060389
Name:PEREZ, ARMINDA (MD)
Entity Type:Individual
Prefix:
First Name:ARMINDA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1108
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-8108
Mailing Address - Country:US
Mailing Address - Phone:214-942-2737
Mailing Address - Fax:
Practice Address - Street 1:238 W 10TH ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4523
Practice Address - Country:US
Practice Address - Phone:214-942-2737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5694207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC20397Medicare UPIN
TX8B7666Medicare ID - Type Unspecified
TX8F1118Medicare ID - Type UnspecifiedMEDICARE