Provider Demographics
NPI:1942570932
Name:PEREZ, JAVIER D (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:D
Last Name:PEREZ
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 N ED CAREY DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8286
Mailing Address - Country:US
Mailing Address - Phone:956-365-3286
Mailing Address - Fax:956-365-4540
Practice Address - Street 1:1616 N ED CAREY DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8286
Practice Address - Country:US
Practice Address - Phone:956-365-3286
Practice Address - Fax:956-365-4540
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician