Provider Demographics
NPI:1811032394
Name:ARMINDA PEREZ M.D.P.A.
Entity Type:Organization
Organization Name:ARMINDA PEREZ M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARMINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-942-2737
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:214-942-9919
Practice Address - Street 1:238 W 10TH ST STE A
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:214-942-9919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5694207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179342403Medicaid
TX179342401Medicaid
TX179342403Medicaid