Provider Demographics
NPI:1790468965
Name:PEREZ, CRISTELA (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CRISTELA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 CASTLE HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-0100
Mailing Address - Country:US
Mailing Address - Phone:956-961-6393
Mailing Address - Fax:
Practice Address - Street 1:208 STARR ST
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-2734
Practice Address - Country:US
Practice Address - Phone:956-514-1643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1129221363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily