Provider Demographics
NPI:1861012585
Name:PEREZ, REBECA ALEJADRA (OTR)
Entity Type:Individual
Prefix:
First Name:REBECA
Middle Name:ALEJADRA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 VIA ROJAS DR
Mailing Address - Street 2:
Mailing Address - City:HORIZON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79928-7495
Mailing Address - Country:US
Mailing Address - Phone:915-408-2889
Mailing Address - Fax:
Practice Address - Street 1:406 CHELSEA ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-1708
Practice Address - Country:US
Practice Address - Phone:915-307-7612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120836225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist