Provider Demographics
NPI:1023870078
Name:PEREZ, ANDREA (FNP-BC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANDREA HERNANDEZ, RN
Mailing Address - Street 1:5224 75TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2525
Mailing Address - Country:US
Mailing Address - Phone:806-712-1096
Mailing Address - Fax:806-771-2093
Practice Address - Street 1:11212 STATE HIGHWAY 151
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4498
Practice Address - Country:US
Practice Address - Phone:210-703-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1145672363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily