Provider Demographics
NPI:1871199620
Name:PEREZ, CHRISTI (CHPT)
Entity Type:Individual
Prefix:
First Name:CHRISTI
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:CHPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3849 HERMOSA DR
Mailing Address - Street 2:
Mailing Address - City:KINGSLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78639-5253
Mailing Address - Country:US
Mailing Address - Phone:512-755-7105
Mailing Address - Fax:
Practice Address - Street 1:1211 N US HIGHWAY 281
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-4501
Practice Address - Country:US
Practice Address - Phone:830-693-8417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX291516OtherTEXAS STATE BOARD OF PHARMACY