Provider Demographics
NPI:1982663274
Name:PEREZ DREW, ANGELA GABRIEL (MPT)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:GABRIEL
Last Name:PEREZ DREW
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 FLORIDA ST SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-3831
Mailing Address - Country:US
Mailing Address - Phone:505-270-4231
Mailing Address - Fax:
Practice Address - Street 1:2050A SECOND STREET SE
Practice Address - Street 2:
Practice Address - City:KIRTLAND AIR FORCE BASE
Practice Address - State:NM
Practice Address - Zip Code:87031-8297
Practice Address - Country:US
Practice Address - Phone:505-846-3200
Practice Address - Fax:505-866-1767
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3204225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist