Provider Demographics
NPI:1184107716
Name:PEREZ, KRYSTINA GUAJARDO (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KRYSTINA
Middle Name:GUAJARDO
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 CYPRESS SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-6726
Mailing Address - Country:US
Mailing Address - Phone:361-726-3059
Mailing Address - Fax:
Practice Address - Street 1:3634 GLENN LAKES LN STE 103
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4062
Practice Address - Country:US
Practice Address - Phone:281-947-2736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113103235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist