Provider Demographics
NPI:1952815524
Name:CARRAZANA PEREZ, YOANDRE MICHEL (SA-C)
Entity Type:Individual
Prefix:
First Name:YOANDRE
Middle Name:MICHEL
Last Name:CARRAZANA PEREZ
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 ROLIDO DR APT 107-2
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-4373
Mailing Address - Country:US
Mailing Address - Phone:305-244-1731
Mailing Address - Fax:
Practice Address - Street 1:2800 ROLIDO DR APT 107-2
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-4373
Practice Address - Country:US
Practice Address - Phone:305-244-1731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-18
Last Update Date:2017-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17-595246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant