Provider Demographics
NPI:1851381214
Name:PEREZ, FRANCISCO M (DMD MSD)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:M
Last Name:PEREZ
Suffix:
Gender:M
Credentials:DMD MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4728 S JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6199
Mailing Address - Country:US
Mailing Address - Phone:956-878-1222
Mailing Address - Fax:956-878-1228
Practice Address - Street 1:4728 S JACKSON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-6199
Practice Address - Country:US
Practice Address - Phone:956-878-1222
Practice Address - Fax:956-878-1228
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201371223S0112X, 204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX155175607OtherCSHCN DENTAL MEDICAID
TX155175606OtherTHSTEPS DENTAL MEDICAID
TX155175609OtherCSHCN MEDICAL MEDICAID
TX155175608OtherTRADITIONAL MEDICAID
TX155175607OtherCSHCN DENTAL MEDICAID