Provider Demographics
NPI:1710925805
Name:PEREZ, LILLIAN ELIZABET (DO)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:ELIZABET
Last Name:PEREZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1739 SCHERTZ PKWY
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-1639
Mailing Address - Country:US
Mailing Address - Phone:210-491-8179
Mailing Address - Fax:210-590-2664
Practice Address - Street 1:1739 SCHERTZ PKWY
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1639
Practice Address - Country:US
Practice Address - Phone:210-491-8179
Practice Address - Fax:210-590-2664
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9940207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0045MAOtherBCBS GROUP
TX8R1750OtherBCBS PIN#
TX8C9869Medicare ID - Type Unspecified
TX0045MAOtherBCBS GROUP